ORAL ANSWERS TO QUESTIONS

HOME DEPARTMENT

The Secretary of State was asked—

Violence Against Women and Girls

Andrea Leadsom: What progress has been made on the Government’s action plan for ending violence against women and girls; and if she will make a statement.

Jane Ellison: What progress has been made on the Government’s action plan for ending violence against women and girls; and if she will make a statement.

Lynne Featherstone: The action plan on tackling violence against women and girls was published on 8 March this year, and we have already delivered in several areas. We have provided more than £28 million of stable Home Office funding until 2015 for local specialist services, £900,000 of which has been made available until 2015 to support national helplines, and we have implemented legislation on multi-agency domestic homicide reviews after every domestic murder.

Andrea Leadsom: In the light of our terrible economic position, will my hon. Friend reassure me that the vital work being done by women’s refuges in Northampton will not be cut?

Lynne Featherstone: My hon. Friend is right to highlight the importance of women’s refuges. The Home Office has sent out a loud and clear message to local authorities by ring-fencing stable funding of £28 million and by saying to them, “You should do the same. These are not soft targets.” It would be a great shame if Northampton council chose to ignore that message.

Jane Ellison: Further to the Minister’s reply, will she respond specifically on female genital mutilation, which is a significant problem in this country as well as in the developing world? The Metropolitan police are taking it very seriously, but hundreds of women in London alone present every year with appalling complications associated with pregnancy and childbirth. Can we make this matter a priority, and work with all the agencies and charities to eliminate this abominable practice?

Lynne Featherstone: Hon. Members on both sides of the House will agree with my hon. Friend—female genital mutilation is a brutal act of child abuse. On 24 February, I launched new multi-agency practice guidelines to raise awareness of FGM. One important symptom that I imagine hon. Members and others do not know of is that girls can be absent when they go to the toilet for a long time—say, 30 minutes. It is important that teachers and nurses understand that, and that we all highlight such symptoms.

Bridget Phillipson: Specialist police domestic violence units have saved lives and improved the way in which police forces handle domestic violence across their force areas. What pressure is the Minister bringing to bear across Government so that chief constables are encouraged to protect those vital front-line services?

Lynne Featherstone: The message we continually send to forces throughout the country is the importance of supporting the sector and taking action on domestic violence, and I hope chief constables are listening today.

Stephen Twigg: May I press the Minister on domestic violence? I chair Chrysalis, the Liverpool domestic violence charity, and Merseyside police force is one of a number that have cut their domestic violence units. Will the Home Office intervene to ensure funding so that forces such as Merseyside can have domestic violence units?

Lynne Featherstone: The Government’s message is loud and clear, but, as I said, it is up to the local chief constable on the ground. I hope chief constables are listening to that important message, which the hon. Gentleman is right to raise.

Elfyn Llwyd: Is the Minister aware of a campaign with which I am involved to introduce changes to the Protection From Harassment Act 1997 in respect of cyber-stalking? Many young women and girls are terrified by what is happening to them day after day and the law needs changing. Will the Minister meet a small group to discuss where the law is failing and where we need to put it right?

Lynne Featherstone: The Government recognise people’s concerns about the legal definition of stalking—cyber-stalking or stalking in other contexts—and about how the 1997 Act is applied. I am happy to meet the group that the right hon. Gentleman mentions.

Police Accountability

Nadhim Zahawi: What recent steps she has taken to increase the accountability of police forces to the public.

Theresa May: The Police Reform and Social Responsibility Bill will establish directly elected police and crime commissioners in every police area in England and Wales. They will hold police forces to account on behalf of the public and so strengthen the vital link between the public and the police.

Nadhim Zahawi: I thank my right hon. Friend for that answer. Given recent moves to ensure that actions are available to constituents when MPs commit wrongdoings, is such an option being considered in respect of elected police commissioners?

Theresa May: I assure my hon. Friend that any police and crime commissioner who is convicted of an imprisonable offence, regardless of whether they are sentenced to a term of imprisonment, will be disqualified from their post. I think that that answers his question.

Stephen McCabe: Does the Home Secretary plan to listen to the Deputy Prime Minister and delay the introduction of police and crime commissioners?

Theresa May: Starting on Wednesday, when the House of Lords Committee stage of the Police Reform and Social Responsibility Bill begins, there will be proper and due consideration of every aspect of the Bill. However, it is our intention that police and crime commissioners will be introduced across England and Wales.

Tom Brake: Accountability of police forces to the public is essential, but so are robust checks and balances to challenge the actions of any commissioner who exceeds their powers or seeks to interfere in operational policing matters. Will the Home Secretary consider seriously the request from the other place that the new accountability arrangements be piloted and the checks and balances strengthened?

Theresa May: As I said in response to the previous question, there will be proper and careful consideration of all these issues as the Bill goes through Committee and its further stages in the House of Lords. I am aware that issues have been raised about the police and crime panels and how they use properly the checks and balances in place to hold police and crime commissioners to account. It is our intention to introduce commissioners across England and Wales.

Yvette Cooper: The Home Secretary will know that on the Bill’s Third Reading five weeks ago we called on the Government to stop and think about the plans for police and crime commissioners, given the deep concerns about the lack of checks and balances in this American-style reform, but she refused. She will have heard Liberal Democrat Front Benchers’ plea to listen. The Deputy Prime Minister has now said that he supports pilots first, his parliamentary aide said this morning that this is the key area, in addition to the NHS, on which Liberal Democrats want to see changes, and Liberal Democrat peers are proposing a two or three-year pause for proper pilots to take place. Will the Home Secretary tell the House whether she is indeed listening, and whether she will consider amending the Bill to introduce pilots first?

Theresa May: I have to tell the right hon. Lady, after that lengthy question, that I answered the point about our intention regarding pilots in response to the previous two questions. I gently remind her that this is not an idea of which we have no experience: the Labour
	Government made the Mayor of London responsible for overseeing the Metropolitan police and therefore acting as a pilot for police and crime commissioners.

Yvette Cooper: So this, it seems, is the Home Secretary’s answer to the Liberal Democrats: they have done a pilot and it was the Mayor of London. In fact, as she will know, the Mayor of London works under a completely different arrangement, and I am not sure that the Liberal Democrats will see that as the Prime Minister’s so-called listening mode. These American-style plans concentrate considerable policing power in the hands of one person without putting in place the proper checks and balances. They are opposed by crime and policing experts and are deeply illiberal and not very British. The Deputy Prime Minister says he wants to hear a louder Liberal Democrat voice. It sounds like they are shouting, but she is not listening. The so-called new business relationship is just business as usual: the Conservatives take the decisions, the Liberal Democrats take the blame.

Theresa May: It was a coalition agreement commitment that we would introduce directly elected individuals to oversee police forces and to hold them to account, and that there would be proper checks and balances. Far from there not being proper checks and balances, as the right hon. Lady suggests, the police and crime panels will provide real checks and balances to the police and crime commissioner. Perhaps she needs to speak to the shadow policing Minister, the hon. Member for Gedling (Vernon Coaker), who a couple of years ago said that
	“only direct election, based on geographic constituencies, will deliver the strong connection to the public which is critical”.
	We agree with him.

Student Visas

John Howell: What estimate she has made of the likely effect of her policy on student visas on the number of visas issued in the 12 months following its implementation.

Damian Green: The policy will be fully implemented by the end of 2012. From then on, the estimated reduction is about 70,000 main applicant visas a year, plus a further reduction in student dependants of about 20,000.

John Howell: I thank the Minister for that response. Will he add to it by telling us what responses he has received from universities on the student visa changes?

Damian Green: This is an important point because when we proposed this radical change the universities were understandably worried. Following our announcement, however, we have received overwhelmingly positive feedback from the university sector. Indeed, Universities UK has said that the reforms
	“will allow British universities to remain at the forefront of international student recruitment.”
	I am delighted that the policy has been so welcomed by the sector.

Alun Michael: In view of the importance of overseas students to the finances of British universities and to the wider UK
	economy, does the Minister agree with the Home Affairs Committee that students should not be counted within migration numbers?

Damian Green: The problem with the approach of the Home Affairs Committee, which, as the right hon. Gentleman knows, I always take very seriously, is that this is not my definition or the Government’s definition; it is an international United Nations definition that an immigrant is someone who moves to and settles in a country for more than a year. Any attempt to solve the immigration crisis that the Government inherited simply by changing the definitions would not be credible with the British public. People know that we have an immigration problem, and they want stern, robust action to be taken to solve it. That is what the Government are providing, and it is much more effective than changing definitions.

Robert Halfon: Is the Minister aware that, according to a number of stories, in addition to bogus colleges, there are colleges that engage in corrupt practices such as asking students for money in return for certificates? Will the Government take steps to crack down on those colleges as well, as they are often licensed by the Home Office?

Damian Green: Indeed we will. My hon. Friend makes a good point. This is about not just bogus colleges colluding with bogus students but bogus colleges conning would-be genuine students, both of which need to be stamped out. In the past 12 months we have revoked 21 tier 4-sponsored licences and suspended more than 70. We are also increasing our enforcement activities to drive out the widespread abuses we have found.

Gerry Sutcliffe: The Home Secretary and the immigration Minister have told us that the policy of reducing the number of student visas is an integral part of their overall policy to reduce net migration by tens of thousands by 2015, but the reality is that the policy is in tatters. The Home Secretary and the Minister say that that is the policy, but the Business Secretary and the Lib Dems say that it is not. The Prime Minister said recently:
	“No ifs, no buts. That’s a promise we made to the British people.”
	Will that promise be kept, given the agenda and proposals on visitors and relatives, and will he get the Lib Dems’ agreement?

Damian Green: I think there was a question in the middle of that. I am happy to assure the hon. Gentleman that we will of course meet our commitment to reduce net immigration to the tens of thousands by the end of this Parliament. If he is going to talk about confusion, he should talk to the right hon. Member for Normanton, Pontefract and Castleford (Yvette Cooper), who said that immigration was coming down in the last years of the Labour Government, although the figures that we have published show that it was going up. The points-based system without a limit was not solving the immigration crisis that her Government created, and this Government are taking effective action across the board that will resolve the crisis that we inherited.

Community Policing

Christopher Pincher: What steps she plans to take to increase links between police forces and local communities.

Aidan Burley: What steps she plans to take to increase links between police forces and local communities.

Nick Herbert: Reconnecting the police with the communities they serve is at the heart of our police reforms. Regular beat meetings and new local crime maps are already enabling communities to hold their local police to account. We will build on this through the introduction of police and crime commissioners, providing an even more visible and accountable link between the police and the public.

Christopher Pincher: Sir Robert Peel, who founded the police force and represented Tamworth, said that the police needed to ensure that they had public support to perform their duties. That is as true today as it was in the 1830s. Will my hon. Friend congratulate Staffordshire police on doing just that? By cutting their back office and reorganising their organisation, they have been able to ensure that front-line services are not cut.

Nick Herbert: I strongly agree with my hon. Friend. Staffordshire police is a very good example of a force that has taken the decision to make savings while protecting neighbourhood policing. In so doing, it is ensuring the continuation of that visible presence that the public value.

Aidan Burley: Under the current system, only 7% of the public understand that they can approach a police authority if they are dissatisfied with the standard of service provided. Will my hon. Friend outline what he is doing to improve this democratic deficit in police governance and end Labour’s woeful legacy on police complaints?

Nick Herbert: I agree: we are strengthening the police complaints system, while also proposing to strengthen police accountability through a democratic reform. Police authorities are invisible to the public. That will change when directly elected police and crime commissioners are elected by the people who will be able to hold their force to account; at the same time, the operational independence of chief constables will be protected.

Kerry McCarthy: The Minister will be aware that Avon and Somerset police have had a difficult job recently in having to police disturbances in the city of Bristol. What help can the Department give that force as it tries to rebuild relationships with the community? More particularly, the cost of the policing operation over the bank holiday period was astronomical, so will any help be available for the force to cope with it?

Nick Herbert: We of course support the action the police took to uphold the rule of law. I particularly want to pay tribute to officers who were injured: violence against anybody is unacceptable, but it is totally unacceptable when it is used against police officers, and
	I am sure that the whole House will wish to support the police in their action. There are established procedures whereby forces can apply if they have incurred exceptional costs, and I am sure this force will know how to do so.

Karen Buck: My borough has been privileged to have an outstanding team of safer neighbourhood sergeants, who provide consistent contact with local communities, yet we are told that it is those sergeants who are most likely to be cut as the number of London police is reduced. Will the Minister assure me that safer neighbourhood sergeants, who take the lead in local communities in bringing the police and the public together, will be protected?

Nick Herbert: The hon. Lady knows that these decisions are taken by the commissioner of the Met, the Metropolitan Police Authority and the Mayor, and the Mayor has said that he wishes to begin recruiting again to maintain officer numbers and to protect safer neighbourhood teams. The force proposes to share sergeants between some of the smaller boroughs; that is a matter for them as they seek to ensure value for money and to keep officers on the streets, where the public want to see them.

Antisocial Behaviour

Caroline Nokes: What plans she has to assist local communities in tackling antisocial behaviour.

Julian Sturdy: What plans she has to assist local communities in tackling antisocial behaviour.

Gavin Williamson: What plans she has to assist local communities in tackling antisocial behaviour.

Brandon Lewis: What plans she has to assist local communities in tackling antisocial behaviour.

James Brokenshire: Alongside our proposed reforms to police and partners’ powers to tackle antisocial behaviour, we plan to give communities the right to force agencies to take action where they have failed to do so. Elected police and crime commissioners, and street level crime maps, will also increase the focus on the issues that matter most to local people.

Caroline Nokes: I thank the Minister for that response, but seek assurances on what the Government are doing to help ensure that persistent antisocial behaviour is dealt with by local authorities, the police and other agencies, and in particular on how the Government plan to support existing schemes such as Test Valley borough council’s CREW—community respect and environment week—initiative.

James Brokenshire: Clearly, antisocial behaviour is, at its core, a local issue, so it lends itself to local solutions. As 10,000 incidents are reported every day, I doubt whether any Member will not have a constituency case
	that touches on the subject. The powers on which we are consulting until 17 May are very much about local communities and equipping local agencies to deal with the problems they see, trusting their judgment to get on with the job.

Julian Sturdy: Further to the Minister’s response, how will constituents in my York Outer constituency be able to use the proposed community triggers to force police authorities and local councils to tackle antisocial behaviour?

James Brokenshire: I am grateful to my hon. Friend for highlighting the proposal on which we are consulting, which aims to enable communities to ensure that the police and local councils come together to respond to complaints that perhaps are not being addressed effectively. This is a positive way to deliver action, responding to the problems of antisocial behaviour in communities. We think that this is an important reform and we propose to take it forward.

Gavin Williamson: What additional programmes will be introduced to stop perpetrators of antisocial behaviour bringing misery to communities that just want safe streets and the rule of law and order?

James Brokenshire: My hon. Friend makes his point very well. We have been working closely with the housing Minister to ensure stronger powers to evict those who are most responsible for antisocial behaviour on housing estates. There must be proper deterrents to ensure that relief is given to hard-pressed communities that are suffering as a result of such behaviour.

Brandon Lewis: The police in Great Yarmouth have done excellent work in preventing antisocial behaviour by early intervention with voluntary local groups such as the Kickz project. Does the Minister agree that such intervention can have a hugely beneficial impact, and will that be reflected in the new proposals?

James Brokenshire: I congratulate the communities in my hon. Friend’s constituency on the practical measures they are taking to prevent antisocial behaviour. When interventions, orders and sanctions are required, it is important that they can be obtained speedily. As that has not happened in the past, the need for the police and local authorities to be able to secure the orders they require quickly is at the core of our proposals.

Keith Vaz: Fiona Pilkington and her daughter committed suicide after suffering years of abuse from youths in Leicestershire. As the Minister will recall, the inquest jury noted that they had contacted the police 33 times, but that no link had been made between the complaints that had been made. The Government are rightly examining police performance. Will the Minister assure the House that this issue will remain a priority? The only way of preventing such tragedies is to ensure an immediate and serious police response.

James Brokenshire: I agree very much with the right hon. Gentleman. We have taken practical measures with police forces around the country to ensure that when complaints are made issues of vulnerability and
	repeat calls are picked up quickly, and so that tragic cases such as that of Fiona Pilkington can be identified much more efficiently and effectively. The provision of that practical relief is an important part of the changes we are seeking.

Chris Bryant: I am sorry, but all this talk about community triggers and community maps is just a load of guff. The South Wales police force area contains two large cities that have to be policed. A large number of royal occasions and sporting events have to be policed. The last problem to which any time is devoted, especially when major cuts are being made to the South Wales police budget, is antisocial behaviour in areas such as the Rhondda. What will the Minister do to ensure that the police are given the instructions they need to tackle the real problems that people face, and that there is money with which to tackle it?

James Brokenshire: I am glad that the hon. Gentleman got to the question in the end. I remind him again of our responsibility and of the problems the Labour party left us, because there is still no recognition of that. We are giving the police the power they need to respond to the problems in the hon. Gentleman’s community and the communities of other Members throughout the House.

Andrew Gwynne: The Minister wants to introduce some form of direct election to improve accountability in local policing. Is he listening to the people of Greater Manchester, where the Government’s cut of nearly 1,400 police officers, which would have a disastrous effect on the battle against antisocial behaviour, was rejected so resoundingly on 5 May?

James Brokenshire: Here is another hon. Member who is still in denial. We believe that the financial settlement is fair and manageable, and that it need not have an impact on the fight against crime and antisocial behaviour on our streets. We are giving the police and local authorities the powers they need to respond to the problem, and, unlike the Labour party, which failed to deal with it in so many ways, we are committed to taking action to provide relief for our communities.

Diana Johnson: Given that the proposed criminal protection injunctions will weaken the sanctions available to the courts to punish and deter those engaging in antisocial behaviour, is it not clear that, at least in this instance, the “soft on crime” Liberal Democrat voice is being heard loud and clear in the Home Office?

James Brokenshire: The hon. Lady is wrong on that point, and I remind her of what the victims commissioner, Louise Casey—the antisocial behaviour tsar under the previous Government—said when we launched our consultation on the new antisocial behaviour powers:
	“I am heartened by the announcement of the new proposals today that put tough enforcement action against perpetrators at the centre.”
	The hon. Lady might not see or recognise it, but that is the case.

Mark Spencer: Nottinghamshire police have made good progress on antisocial behaviour over the past 12 months by getting police officers out from behind their desks and on to the streets, but does my hon. Friend agree that they are not assisted by being bound to their 25-year private finance initiative contract, signed by the previous Administration?

James Brokenshire: As my hon. Friend makes clear, a number of the PFI and other contracts that were entered into did not necessarily deliver good value for money. On the costs that fall locally, we are working with forces to identify savings in operational PFI projects, including the option of renegotiating contracts to ensure ongoing value for money and service to our community.

Cannabis

Paul Flynn: What her policy is on the use of cannabis for medicinal purposes.

James Brokenshire: We do not recognise cannabis in its raw form to have any medicinal purposes; cannabis is a harmful drug. However, Sativex, a cannabis-based medicine, has been approved by the Medicines and Healthcare products Regulatory Agency as a safe and effective medicine for patients with multiple sclerosis.

Paul Flynn: In Canada, Austria, Germany, the Netherlands, Finland, Italy, Israel, Spain, Portugal and parts of the United States, patients can take medicinal cannabis in its natural form safely and legally. Why are seriously ill patients in our country, particularly those suffering the symptoms of multiple sclerosis, forced to break the law when they want to use their medicine of choice?

James Brokenshire: The advice we have received from the Advisory Council on the Misuse of Drugs confirms that cannabis is a significant public health issue. I certainly sympathise with anyone suffering from a debilitating illness, but we do not condone any illicit drug taking, for whatever reason. As I have indicated, GPs may prescribe Sativex in the circumstances mentioned. That is available, and we are dealing with its regulation.

David Burrowes: That is not the most significant medical issue in relation to cannabis. In its higher form in particular, there are significant risks to young people, such as the probable causal link to mental illness, especially psychosis and schizophrenia. Will the Minister reassure the House that the Government will continue to take a tough line and ensure effective enforcement of the law on possession of cannabis?

James Brokenshire: I know that my hon. Friend takes these issues incredibly seriously, and has focused on drugs policy for some time. I assure him that our position is that the classification of “illegality” can influence behaviour and be a meaningful factor when people are contemplating taking drugs. That is why we do not have any proposals to change the classification of cannabis, and why we place so much importance on
	the current legal arrangements in ensuring we reduce supply and deal with these problems. There is no change of policy.

Alcohol Sales (Children)

Sarah Wollaston: What legislative proposals she plans to make for further restrictions on the sale of alcohol to children.

Theresa May: The Government do not tolerate the sale of alcohol to children. The Police Reform and Social Responsibility Bill will double the maximum fine from £10,000 to £20,000, delivering on a coalition agreement commitment, and will extend the minimum period of voluntary closure that can be given for persistent under-age sales. We are also committed to working with the Sentencing Council and the Crown Prosecution Service to prosecute those found guilty of persistent under-age selling and to use the full range of sentences available.

Sarah Wollaston: In England alone, about 36 children every day are admitted to hospital as a result of alcohol-related harm. Will the Home Secretary consider making the reduction of alcohol-related harm an objective, and prioritise it in licensing decisions?

Theresa May: I am grateful to my hon. Friend for raising this issue, particularly given her experience as a general practitioner. I recognise the picture she paints, and I would add that half of all violent assaults are believed to be alcohol related, so there is a real issue with alcohol that we need to consider. We think there is merit in making health a material consideration under the Licensing Act 2003. The Police Reform and Social Responsibility Bill will make certain health bodies responsible authorities under the Act. We are talking to the Department of Health about what we might do to ensure that the health aspects of alcohol are properly taken into account.

Ian Lucas: Will the Government’s proposed moratorium on regulation for micro-businesses apply to these regulations?

Theresa May: I thank the hon. Gentleman for his question. No, it is not intended that it relate to licensing.

Child Protection

Margot James: What progress the Child Exploitation and Online Protection Centre has made in its investigation into the grooming of vulnerable teenage girls for sex.

Theresa May: I am grateful to my hon. Friend for raising this issue. Good progress has been made since CEOP commissioned its thematic assessment of localised grooming in January. A range of responses has been received from a variety of sources, including police forces, charities and local safeguarding children boards. Analysis of the data is ongoing and the final report is expected to be published in June.

Margot James: I thank the Home Secretary for her answer. Whether or not CEOP forms a discrete part of the new national crime agency, what steps will be taken to work with mosques and Asian communities to make this organised exploitation of young girls culturally unacceptable?

Theresa May: My hon. Friend’s question enables me to say how strongly we support CEOP’s work. We want it to be a lead law enforcement body in protecting children nationally, so I am pleased to announce that it will form part of the new national crime agency and will continue to build on the work it is doing. In examining the issue of grooming, it is important to wait for CEOP’s thematic report, see the extent of this problem and, obviously, take CEOP’s advice on any action that needs to be taken in relation to particular communities, but I do not think we should see this as an issue that relates only to particular communities.

Jenny Chapman: What progress has the Home Secretary made in requiring sex offenders to register their online identities?

Theresa May: I thank the hon. Lady for raising this issue. I cannot give her an exact date, but fairly shortly we will be launching a consultation exercise in response to issues that have arisen concerning the sex offenders register. The question of online identities was raised in this House when I made the statement on the response to the F and Thomson case, and we are taking it on board, so I ask her to wait for that consultation.

Immigration and Asylum Law

Julian Huppert: What her policy is on measures to ensure that children born overseas to unmarried male British citizens before 2006 are treated in a manner equivalent to those born after 2006.

Damian Green: I am grateful to my hon. Friend for reminding the House of this odd hangover from previous legislation. Children born overseas to unmarried British fathers before July 2006 were unable to acquire citizenship by descent from their father. However, the UK Border Agency will register such people as British citizens if an application is made before their 18th birthday.

Julian Huppert: I thank the Minister for those comments. He was also sympathetic when my hon. Friend the Member for Carshalton and Wallington (Tom Brake) raised this matter two years ago. Will he seek a legislative opportunity to correct this situation by statute rather than rely on discretion, which may or may not be applied to children who may or may not be inside the country?

Damian Green: As I said, my hon. Friend makes a valid point. There is, however, an established registration route for children born to British unmarried fathers under section 3 of the British Nationality Act 1981, which allows the Home Secretary to register any child under the age of 18 as a British citizen, and this discretion has been used for many years. Of course those who are
	not able to register because they are over the age of 18 can instead naturalise as British citizens if they are resident in the UK and meet the requirements for naturalisation. As he says, any change to the nationality law would have to be made through primary legislation and there is no appropriate vehicle before the House at the moment.

Police (Regulation A19)

John Mann: How many police officers she expects to retire under rule A19 in 2011.

Nick Herbert: Chief officers are responsible for managing the resources and staff available to them to ensure effective policing. Operational decisions, including on the impact of using their powers under regulation A19, are rightly a matter for them.

John Mann: What kind of answer is that? There is a seasonal saying at this time of year: “Cast not a clout till May be out.” Why are decent, hard-working, brilliant, experienced police officers in my area, in Nottinghamshire and across the country being forced to give up their jobs because of this Government, when my community and others want to keep them and when they want to keep working?

Nick Herbert: From the hon. Gentleman’s outrage, hon. Members would not know that under the previous Labour Government Nottinghamshire police numbers fell between 2004 and 2009. This is a procedure used by chief constables that the previous Labour Government chose to renew. The fact is that officers ordinarily retire after 30 years and they do so with a full and generous pension.

Anna Soubry: I do not know whether the hon. Member for Bassetlaw (John Mann) has discussed this matter with the chief constable of Nottinghamshire, but I did on Friday. Does the Minister agree that it is imperative that when chief constables make these difficult decisions they should consult not only their communities but the Police Federation to ensure that we retain the best front-line officers?

Nick Herbert: I agree with my hon. Friend. Let me put this in context. I understand that some 130 of some 2,500 officers in the force may be retired under this provision. The independent Winsor review of pay and conditions recommended that this procedure should continue to be available to chief officers.

Vernon Coaker: Approximately 2,000 police officers across the country with more than 30 years’ experience are being forced to retire under regulation A19 because of the 20% front-loaded cuts imposed by the Government. As we have heard from my hon. Friends, these include front-line beat officers, response officers, detectives and firearms specialists, although some, as we know, have been asked to return as volunteers. I want to ask the Minister a specific question: has he carried out an assessment of the cost implications for the Home Office, along with any other
	associated costs, of forcibly retiring these 2,000 experienced officers? Did any such assessment show that the cuts really were in the interests of the taxpayer?

Nick Herbert: I repeat to the hon. Gentleman that these decisions are made by chief constables in the interests of the efficiency and effectiveness of the force. This is a procedure that the previous Government chose not to change. The fact is that the total number of officers retiring with more than 30 years’ service who might be eligible for this procedure is about 3,000 of a total 140,000 officers. The question that the Labour party simply cannot answer is how it would have achieved the savings of more than £1 billion a year, which are the cuts it says it would have imposed on the British police.

Asylum Seekers

Stephen Phillips: What progress her Department has made in reducing the number of bogus asylum seekers.

Theresa May: A system that makes timely decisions and removes people who have no right to stay in the UK is the biggest deterrent to false claims. The Government are committed to increasing the speed and quality of the processing of asylum claims, and the UK Border Agency is making faster decisions and removing people more quickly.

Stephen Phillips: I am grateful to my right hon. Friend for that answer. Bogus asylum claims result in a huge cost to the taxpayer through asylum support. What will the Government be doing to reduce the amount of money spent on asylum support?

Theresa May: I am happy to tell my hon. and learned Friend that we have reduced the cost of asylum support by more than £100 million from the 2009-10 total, delivering substantial savings to the taxpayer. That is the result of action that has been taken to ensure that we clear up the legacy of old asylum cases, speed up the processing of asylum claims and remove more quickly those not entitled to protection. Our asylum improvement project aims to go further.

National DNA Database

Philip Davies: What assessment she has made of the potential effects on the number of crimes solved of proposed changes in the national DNA database.

James Brokenshire: The changes we propose to limit the retention of the DNA profiles of people not convicted of any offence are based on the coalition agreement commitment to introduce the protections of the Scottish system in order better to balance public protection and individuals’ rights. The statistics show that simply increasing the number of DNA profiles on the DNA database does not necessarily increase the number of detections made via that database.

Philip Davies: There are already 150,000 crimes in which a DNA sample has been taken at the crime scene and not been matched to anybody on the database. Surely the Minister accepts that having fewer people on the database will mean that fewer matches will be made and fewer criminals will be brought to justice. Will he explain how having more dangerous criminals on the streets enhances my freedoms?

James Brokenshire: I know that my hon. Friend looks at the facts and circumstances, so I ask him to look at what has happened in the past five years. Since 2004-05, an additional 2 million individuals were added to the national DNA database but there were 4,000 fewer detections as a consequence.

Northumbria Police

Chi Onwurah: What discussions she has had with Northumbria police on the appropriate level of policing over the period of the comprehensive spending review.

Nick Herbert: I have regular discussions with chief constables and police authorities on a range of issues about policing. Decisions about the number of police officers and other police staff engaged by Northumbria police are a matter for the chief constable and the police authority.

Chi Onwurah: Recorded crime across Tyne and Wear fell by 14% in 2010 and has fallen by 47% since 2003. That has made a real difference in the lives of my constituents, but they are now naturally worried to learn that this Government apparently regard the big society as a substitute for proper policing. What reassurance can the Minister offer?

Nick Herbert: I hope the hon. Lady will be reassured by the comments of the new chief constable of Northumbria, who was previously the temporary chief constable. She said recently:
	“I am determined that we will continue to reduce crime and protect police services that local communities across Northumbria want”.
	She went on to say that her absolute priority was to improve front-line policing and the service delivered to communities.

Topical Questions

Gavin Barwell: If she will make a statement on her departmental responsibilities.

Theresa May: As I have previously informed the House, the first duty of Government is to protect the public. Following the death of Osama bin Laden, the overall threat level from international terrorism remains at severe and there is a continuing need for everyone to remain vigilant and to report suspicious activity to the police. Last week’s verdict from the coroner’s inquest into the London bombings on 7 July 2005 reminds us of the real and serious threat from terrorism. I have made a written ministerial statement on the verdict this morning. Across Government, we
	are carefully considering the current recommendations and we will respond in due course, at which time I would expect to make a further statement to the House. Nothing will ever bring back the 52 people who were murdered on that day, but I hope that the comprehensive, open and transparent inquests that have been held have brought some measure of comfort to the families and to all those affected.

Gavin Barwell: I thank my right hon. Friend for her statement. May I press her a little further? One of the coroner’s key findings was about the need for better co-ordination between Transport for London and London’s emergency services. Does the Home Secretary agree that there is a real need to reassure Londoners that if a tragic incident of this sort ever happened again, there would be better co-ordination than there was on this occasion?

Theresa May: My hon. Friend has made a very important and valid point. Of course, a number of the recommendations refer to Transport for London and to emergency responders. The proposals that have come specifically from the coroner will be looked at in great detail and with great care because it is absolutely right that we ensure that the lessons that can be learned from 7 July 2005 are learned.

Yvette Cooper: I welcome the Home Secretary’s words about the 7/7 inquest and add our thanks to Lady Justice Hallett and the team. That inquest brought out the heroism and the tragedy of that terrible day. The moments of bravery shown by the emergency services, many members of the public, those who were directly affected and their families will be remembered, as will the tragic loss of the 52 people who were killed.
	It is important that Lady Justice Hallett’s recommendations are taken forward and that the relevant services have the resources to do that. May I ask the Home Secretary when she expects to be able to report back to the House on the detail of her response to those recommendations? Can she give the House a sense of whether she expects to be able to support the broad thrust of the recommendations because they were each considered in great detail and it is important that they can be taken forward?

Theresa May: I thank the right hon. Lady for her question. On the issue of timing, the formal position is that anybody to whom recommendations are made is given 56 days to respond to the coroner’s report and recommendations. We will be responding within that timescale but, as I indicated in my previous answer, I intend to do so within a timescale that will enable me to make a statement to the House about that response. I am sure she will understand that as the recommendations were made to a number of bodies across government, as well as Transport for London, it is necessary to co-ordinate that response and make sure that all considerations have properly been taken into account.
	On the right hon. Lady’s final point, significant improvements have already been made since 7 July 2005, but the Government are always looking to learn lessons from that incident and any other incidents that take place—should they do so. In doing that, of course we always put at the forefront of our thoughts the
	intention of ensuring that we can provide the highest level of public security and safety possible, but sadly we can never guarantee that no further terrorist incident will take place.

Julian Smith: What is the Home Secretary doing to ensure that all four Yorkshire police forces work much more closely together to reduce costs?

Nick Herbert: Collaboration by police forces is important both to improve operational effectiveness and to save money. A study by Deloitte a couple of years ago found that Yorkshire and the Humber could realise savings of some £100 million over five years by co-operating more effectively. That is the kind of thing that we want all forces to do.

Pamela Nash: Can the Minister confirm that student visitor visas, which have recently been increased to 11 months, will not be included in general immigration statistics?

Damian Green: Yes, as indeed I made clear in answer to a previous question. The definition of an immigrant is somebody who comes here for more than 12 months, so student visitor visas, like tourist visas, are for visitors, not for immigrants. They therefore do not come under immigration limits.

Claire Perry: May I press the Home Secretary a little further on the 7/7 inquest? Like so many MPs in our constituencies on Friday, I was listening to the wall-to-wall coverage of the inquest and was struck by the harrowing stories of the survivors and the surviving family members. It has been nearly six years since the event. Can my right hon. Friend tell us, while we wait for the end of the formal response period, what lessons the security services have learned since the event?

Theresa May: As I said in response to the shadow Home Secretary, the Security Service has indeed made some changes since those events on 7 July 2005, has looked again at what is coming out of the inquest and will look with great care at the two specific proposals that are aimed at the Security Service in relation to the potential for further lessons to be learned. I draw the attention of my hon. Friend and the House, however, to Lady Justice Hallett’s words when she said that there was no evidence at all that the Security Service knew of and therefore failed to prevent the bombings on 7/7.

Paul Flynn: Is any Minister capable of answering a question without blaming the last or the next Labour Government? Can the Home Secretary explain who is responsible for the 350 job losses in Gwent? Efficiency savings will save 20 of them; what about the other 330?

Theresa May: I assume that the hon. Gentleman was speaking about the police, although I do not think the word passed his lips. He asked whether any Minister can get up and not make reference to the mess that we were left by the previous Government. The reason savings are being requested from police forces, and the
	reason across government we are having to make cuts in public sector spending, is the deficit that we were left by the Labour Government. Had Labour been in government, it would be cutting £7 for every £8 that we are cutting. The issue for the hon. Gentleman and his right hon. and hon. Friends is where they would make those cuts.

Mike Freer: The Minister is aware of the 60 or 70 Yemeni Jews who are trapped in Yemen. What can he do to help to facilitate the visa applications of those families with strong British links?

Damian Green: I am grateful to my hon. Friend for bringing up this issue. He will understand that it would be inappropriate for me to provide a running commentary at the Dispatch Box on individual applications for asylum or any other form of immigration, but I am aware that he has written to me about the matter and I will reply to him shortly.

John Robertson: Will the Minister say a little more about how happy the universities were about the new visa system, and in particular what he would say to Glasgow Caledonian university, which has been suspended from sponsoring foreign students and had a 28-day suspension imposed on it? What would he say to the university, which finds the situation difficult and the sentence disproportionate?

Damian Green: I would say to Glasgow Caledonian university, and to the hon. Gentleman, what I would say to any university: all tier 4 sponsors who are given the privilege of bringing people to this country must ensure that they fulfil their sponsorship duties and that their students comply with the requirements of the immigration rules. As he knows, the tier 4 licence was suspended on 20 April following concerns about abuses of the immigration system. The university was given 28 days, from the date of suspension, to make representations against the decision. We are still within that 28-day period and obviously are in dialogue with the university. I hope that he will endorse the fact that we have immigration rules in this country and that they need to be enforced.

Duncan Hames: It will soon be 50 years since the last royal commission on policing, during which time the challenges faced by our police forces have changed dramatically, as have the expectations placed on them. Will the Minister consider the case for a fresh royal commission?

Nick Herbert: I think it was Harold Wilson who said that royal commissions take minutes and waste years. More recently, Her Majesty’s inspectorate of constabulary has said that there is no time for a royal commission. There are important and urgent decisions that we need to take in relation to police financing and enhancing accountability, which is what the Government intend to do.

Paul Goggins: Ministers have confirmed in parliamentary answers that in the period 2010-12, 45 individuals with terrorist convictions will be released back into the community. Can the Home Secretary assure the House that all relevant agencies will work closely together, that they
	will have the necessary resources to manage those offenders back into the community and that she and the Justice Secretary have a clear understanding that anyone in breach of their licence conditions will be returned to prison immediately?

Theresa May: The right hon. Gentleman makes a very important point. It is, of course, essential that the various agencies involved work together. I can assure him that they will be working together, as they have been. One of the developments of recent years, which is very welcome, is the way in which the Security Service and the police have worked together on counter-terrorism matters. They will continue to do so and are very conscious of the issues relating to the release of offenders who have completed their prison sentences.

David Davis: A year ago, I was approached by a whistleblower with an allegation that there had been criminal misuse of CCTV and automatic number plate recognition information by the Home Office and a part of the Metropolitan police. I established that the individual knew the insides of the organisations concerned and ongoing operations and that he had no obvious reason for malice or deceit. I sent the information to the Home Secretary. Since then, despite a number of reminders, I have had no response from the Home Office. Will she now tell me when that investigation will conclude?

Theresa May: I will go back and ensure that the matter is brought to my attention and that I am able to give my right hon. Friend a response as soon as possible.

Angela Smith: Police community support officers play an important role in policing our communities, so will the Minister join me in congratulating the new Labour administration in Sheffield on its decision to restore the funding for 10 PCSA posts that had been cut by the previous Lib Dem administration?

Nick Herbert: The Government decided to maintain the ring-fencing for the neighbourhood policing fund outside London so that funding would continue to be available for police community support officers, whom we support because they do an important job as part of the policing family, working alongside police officers.

David Ruffley: The Home Secretary’s plans to cut police red tape, which were announced this morning, will sadly save each police officer only 20 minutes each week. Why is she not being more radical?

Theresa May: This is not the end of the story. Indeed, we are working in a number of ways to ensure that we continue to cut police bureaucracy. My right hon. Friend the Minister for Policing and Criminal Justice is looking at savings in bureaucracy that can be made across the criminal justice system. Chris Sims, the chief constable of West Midlands police, is the ACPO lead on reducing bureaucracy and is looking at other ways of reducing bureaucracy. Sara Thornton, the chief constable of Thames Valley police, is looking to reduce the 600 different
	guidance documents that ACPO provides to police forces to fewer than 100. Those examples show that this is work in progress, but our commitment is absolutely clear.

Ian Austin: Given the civil war that has erupted among Government Members, may I offer the Home Secretary some support from the Opposition and tell her how grateful I am for her enormous contribution to our stunning electoral results in Dudley North last week, when we won for the first time ever two seats in Gornal—Upper Gornal and Woodsetton? That would not have been possible had it not been for the public anger at the huge number of police officers she is sacking in the west midlands.

Theresa May: I think that there was something at the end there about policing in the west midlands, but I did not quite catch it. I should be very happy to explain to the hon. Gentleman, as I did earlier, that changes to the budget in the west midlands, as to every other police force, are a direct result of the financial mess that was left by the previous Labour Government. I also say to him that it ill becomes Labour to crow about election results, given that in last week’s election it failed to take an overall majority in Wales, failed in Scotland and stood still in England. I suggest therefore that he keep a little quieter about it in future.

Jason McCartney: What consultation has taken place with universities, such as the university of Huddersfield, to assess the impact of changes to student visas and the number of students who stay on after their studies to take the post-study work route?

Damian Green: As my hon. Friend may have heard me say earlier, there was a full consultation. It obviously included the university of Huddersfield and was widely welcomed by universities. We now have a system whereby graduates can stay on so long as they have been offered a specific graduate-level job. To answer his precise question, we calculate that the effect on numbers will be that instead of 38,000 staying on as before, roughly 19,000 will stay on in future.

Katy Clark: The Home Secretary will be aware of the concerns about the activities of under-cover police officers, such as Mark Kennedy. Her Majesty’s inspectorate of constabulary is carrying out a review; will the Home Secretary undertake to make a statement to the House once the outcome of that review is known?

Nick Herbert: We will certainly keep the House updated, but I think it best to await the outcome of that review.

Mark Pawsey: I recently spent time with special police constables in Rugby, targeting antisocial behaviour and under-age drinking by sticking Alcohol Watch stickers on bottles and cans. Will the Home Secretary join me in recognising the very valuable work carried out by the special constabulary?

Theresa May: Yes, I am very happy to join my hon. Friend and, I am sure, others across the House in recognising the valuable work that the special constabulary
	undertakes. Indeed, we would like to encourage more people to become specials, because they perform a very important role in policing their communities.

Anne Begg: Now that Aberdeen passport office has closed, my constituents face a long journey for a face-to-face interview about their first passport. They are expected to travel to Dundee, 70 miles away, but, because of the extra work caused by the closure of other offices throughout north-east Scotland, they have now been told that they will have to
	go either to Edinburgh or even to Newcastle. It appears that the alternative arrangements that the Government promised have not been put in place, so will the Minister look at the issue to make sure that they are put in place and it is not impossible for my constituents to get a passport?

Damian Green: I am grateful to the hon. Lady for drawing that issue to my attention. I will certainly look into the individual circumstances of her constituents applying for a passport for the first time.

NEW MEMBER

The following Member took and subscribed the Oath required by law:
	Jonathan Ashworth, for Leicester South.

Points of Order

Tom Watson: On a point of order, Mr Speaker. May I ask whether you have had notification of a statement from the Government on delaying the decision on the BSkyB takeover bid in the light of the criminal trial just being launched involving computer hacking and contractors with News International?

Mr Speaker: I have received no indication of any such statement. That is an explicit response to the hon. Gentleman. However, I am grateful to him for his point of order.

Thomas Docherty: On a point of order, Mr Speaker. Recently, the Procedure Committee published its eagerly sought report on hand-held electronic devices and tweeting in the Chamber. Will you update the House on whether that report has simply been accepted as a new procedure for the House or whether we will have a full debate on the matter and a vote?

Mr Speaker: The short answer to the hon. Gentleman is that the report would need to be debated by the House. That has not yet happened. However, I would certainly expect that before any decision were made and enforced, right hon. and hon. Members would have had the opportunity to debate the issues, which I know are of great and consuming interest to the hon. Gentleman and others.

Thomas Docherty: Further to that point of order, Mr Speaker.

Mr Speaker: I do not think there can be anything further to it. [ Interruption. ] Well, I will give the hon. Gentleman the opportunity to reflect on the matter for a moment and see whether his point is still valid.

Julian Lewis: On a point of order, Mr Speaker. It was very reassuring, on entering the Palace of Westminster today, to see the flag of the United Kingdom flying from Victoria tower. Given that the European Union has apparently been issuing orders that the EU flag should be flown over public buildings and a photograph sent to Brussels to prove that it has been done, can you tell the House whether you received any such instruction and what your reaction would have been had you received it?

Mr Speaker: I did not, and I will not speculate on matters hypothetical. I have a hunch that that observation was aimed less at the House and more at the Lymington  Times.

Julian Lewis: And the Southern Daily Echo.

Mr Speaker: I am grateful to the hon. Gentleman for his sedentary correction.

Grahame Morris: On a point of order, Mr Speaker. Is there anything you can do to improve the provision of access to quality national newspapers across the parliamentary estate? I am
	particularly concerned at the lack of availability of copies of the
	Morning Star
	.
	[
	Interruption.
	]
	Obviously, Conservative Members are too. Could you confirm to the House whether you are fortunate enough to receive copies in your residence, and whether it is your view that all Members should have the right to a broad and balanced political perspective on the events of the day?

Mr Speaker: I am in favour of a broad and balanced diet of newspapers, because it is analogous to the benefits of a broad and balanced diet more widely. I am not in the habit of regularly reading the newspaper to which the hon. Gentleman refers. I am all in favour of people having access to it if they so wish, but if he is asking whether it is delivered to me, the answer is no.

Gisela Stuart: On a point of order, Mr Speaker. I would be grateful for your advice on whether parliamentary courtesies also apply to the Prime Minister, who, last Friday, together with some of his colleagues, visited Queen Elizabeth hospital in Birmingham, Edgbaston to get some decent advice on how to reform the NHS, but the local Member of Parliament was not notified.

Mr Speaker: The short answer to the hon. Lady’s point of order is that that parliamentary courtesy is expected of every Member of the House, so it most certainly does extend to Ministers.

Thomas Docherty: Further to my point of order, Mr Speaker. While the Leader of the House is present, could you confirm whose decision it will be as to the timetabling of the vote on the Procedure Committee report? Will you, Mr Speaker, or the Leader of the House decide on that?

Mr Speaker: The answer is that these matters are ordinarily determined through the usual channels. If the hon. Gentleman remains interested in this matter, a suitable opportunity for him to pursue it would be at business questions this Thursday. I look forward with eager anticipation to seeing him in his place on that occasion.

Opposition Day

[Un-alloted Half Day]
	 — 
	Future of the NHS

John Healey: I beg to move,
	That this House notes the growing concerns over the Government’s handling of the NHS and the effect its policies are having on hospitals and patient care; and calls on the Government to uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care, to use the present pause in the progress of the Health and Social Care Bill to make fundamental changes, including dropping the damaging and unjustified market-based approach, and to concentrate efforts instead on achieving sound efficiencies, better clinical quality and improved integration of services.
	We have called this debate after the Prime Minister was forced to order an unprecedented pause in his health legislation last month. He was forced to do so because of the growing criticism, confusion and crisis of confidence over the Government’s NHS reorganisation. It was unprecedented because he told his Health Secretary to stop what he was doing while 45 others on the NHS Future Forum work out what he should be doing. It looks as though the Prime Minister is listening to anybody and everybody on the NHS except the Health Secretary.
	We have called this debate after the Deputy Prime Minister’s flagship policy was sunk in the AV referendum last week. He is now trying to find a replacement, and claims that changes to the Health and Social Care Bill are his new No. 1 priority. The Deputy Prime Minister and his party are up to their necks in the Tory NHS plans. He and the Prime Minister co-signed the foreword to the White Paper last summer, and he signed off the NHS legislation in Cabinet before Christmas. He and his Lib Dem MPs have backed the Bill at every stage in Parliament. In Committee, his Lib Dem Health Minister led the rejection of Labour’s amendments—the amendments that he now says he wants to make.
	Now that the Lib Dems are making many of the arguments that Labour has been making since early autumn, people may ask what the Deputy Prime Minister has been doing for the past year, when he changed his mind and why. People may suspect that the deal he is stitching together has more to do with saving his party than safeguarding the NHS.

Sajid Javid: Will the right hon. Gentleman tell the House whether he still believes that the Government’s plans are “consistent, coherent and comprehensive”? If not, when did he change his mind?

John Healey: Indeed, they are comprehensive, consistent and coherent, and they are wrong.

Charlie Elphicke: I thank the right hon. Gentleman for being so generous in taking interventions. He has told the House that the plans are wrong. However, in January 2010, he said to the King’s Fund:
	“The general aims of reform are sound”.
	It seems to me that he has changed his mind.

John Healey: There is nothing wrong with the general aims of the changes, but what the Government are doing is different from what they are saying. In one third of the legislation, they are not setting up GP consortia or reducing bureaucracy in the NHS, but setting up the NHS as a full-blown market. That is the wrong prescription for our NHS, and it is patients who will suffer.

Christopher Pincher: The right hon. Gentleman seems to be suffering from amnesia, which, by the way, is treatable on the NHS. On 30 November, he said that he supported our proposals to move public health functions from primary care trusts to local authorities. If he does not believe in reorganisation any more, how does he intend to achieve that move?

John Healey: In principle, that is a good move. The Opposition, including those of us on the Front Bench, have said that it makes sense in principle to give local authorities a lead responsibility on public health; after all, they are responsible for things that affect public health such as housing, employment and a good environment. The Government’s failure is that local authorities are not getting the powers or resources to do the job properly. The provisions in the Bill will fragment the NHS and make it harder, not easier, for them to do that job.

Dave Watts: Can my right hon. Friend explain why the Secretary of State says in public that the change is not about the privatisation of our hospitals, when in fact that is exactly what his officials are doing behind closed doors?

John Healey: My hon. Friend has been pressing that point with his local hospital, because it is quite clear that the hospital’s managers were forced to look at privatising it and having its management run by a private company. I fear that under the provisions of the Health and Social Care Bill, more hospitals will be driven to the brink and will have to face the prospect of insolvency or a takeover by the private sector companies that are lining up to make the most of the Government’s plans for the NHS.

Grahame Morris: On the transfer of responsibility for public health, can my right hon. Friend explain how withdrawing the funding for the public health observatories, which have informed health policy, will help improve public health?

John Healey: My hon. Friend gives good service on the Health Committee and follows the details of the matter more closely than most in the House. He has an important point, because the quality of health services for patients is inevitably affected by the deep and fast cuts in other areas. People in local authorities are experiencing difficulty in continuing to provide good social care, which is causing problems for the people who depend on that care and for the NHS.

Stewart Jackson: Does the right hon. Gentleman regret the policy of rigging the market in favour of independent sector treatment centres
	in the last Parliament, which some Conservative Members opposed? Does he agree with that policy?

John Healey: The independent sector treatment centres played a part in clearing the backlog and improving waiting lists. They introduced the extra capacity that allowed the Labour Government, through a combination of investment and reform, to achieve the highest levels of patient satisfaction with the NHS ever and the lowest waiting times ever.

Kevan Jones: My right hon. Friend will have seen the nauseating, sanctimonious and preaching sermons of the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) after the election results on Thursday. Does he understand why the right hon. Member for Wokingham (Mr Redwood) and others are concerned that the Liberal Democrats are going to scotch a policy that they have been signed up to from day one?

John Healey: My hon. Friend is absolutely right, and he makes the point that I have begun to make to the House. The Liberal Democrats have been up to their necks in this for the past year, and welcome though their late conversion is, the House is entitled to ask exactly why the Deputy Prime Minister now believes that radical changes to the Health and Social Care Bill are required.

Several hon. Members: rose —

John Healey: I am going to carry on and make a little progress.
	If the Deputy Prime Minister is not going to sell out the principles of the NHS like he has the principles of his party, he must toughen the tests for the Bill and help stop the market free-for-all in the Government’s plans. If he and his party mean what they say, they can start today by backing us and backing the motion. It calls on the Government to drop
	“the damaging and unjustified market-based approach”,
	exactly as the Liberal Democrat spring conference did, and to
	“uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care”.
	There is no mandate for this, the biggest reorganisation in NHS history, either from the general election or from the coalition agreement.

Andrew George: If the right hon. Gentleman is concerned about consistency, he will know that since the publication of the White Paper last year, my concerns about the proposal have been well established. The motion, however, castigates top-down reorganisation. Will he apologise for the previous Government engaging in substantial top-down reorganisations time and time again, including the introduction of the independent sector treatment centres, which lost millions and millions of pounds of taxpayers’ money?

John Healey: Some of the reorganisations in the 13 years of our Government played an important part in the reform and the great gains that patients saw in the NHS. However, it is also the case—and we learn from
	this—that reorganisations often take longer, save less, cost more and have less impact on improving care for patients than envisaged at the outset. We learned that lesson towards the end of our 13 years, which is why we had a period of important stability in the NHS, but it is a lesson that the Conservatives have failed to learn—extraordinarily so, as we all thought that they had learned it, because NHS reorganisation is exactly what the Prime Minister promised not to do before the election.
	The Prime Minister’s broken promise on NHS reorganisation is part of the reason for the growing doubt and distrust about whether he is making the right decisions for the right reasons on the NHS. He promised to give the NHS a real rise in funding, but the Budget this year confirmed a £1 billion shortfall in England. He promised to protect front-line services, but nursing posts are already going, and the Royal College of Nursing expects 40,000 NHS jobs to go in the next four years. The Prime Minister promised a moratorium on hospital A and E, and maternity service closures, but some are now going ahead, and more will follow—without public consultation—under the Health and Social Care Bill plans.

Anne McIntosh: I am following the shadow Minister extremely closely. The last Government opened a treatment centre in my old constituency, Vale of York. I am having great difficulty understanding what we are proposing to do, following what Labour did in York.

John Healey: Let me help the hon. Lady. For the first time, all parts of the NHS, including the commissioning job, will be opened up to private companies and subject to competition. As I have said, independent sector treatment centres played a part in our being able to clear long waiting lists and restore the quality of service to the NHS, as well as in supplementing the mainstream NHS, not substituting for it, which is what will happen under her party’s Bill.

Simon Burns: Just for the sake of balance, will the right hon. Gentleman confirm that such treatment centres were also prime cherry-pickers and that between 2003 and 2009, the private sector was paid £250 million for not carrying out a single operation?

John Healey: The right hon. Gentleman will know from his current position that the premium that we paid in the first wave of treatment centres was stopped in the second wave. He will also know that by the end of our period in government we had stopped the independent treatment centres programme; and he ought to know that built into his Bill’s impact assessment is what it calculates to be a 14% premium, paid to providers under his proposals.

Simon Burns: indicated  dissent .

John Healey: It is in the impact assessment; I suggest that the right hon. Gentleman take a good look at it.

Stephen Dorrell: The right hon. Gentleman has just implied that the Government were proposing to introduce, for the first time, private sector expertise into the commissioning process of the health service. Will he correct that statement to the
	House by confirming that under the world-class commissioning programme, the previous Government explored exactly that proposal?

John Healey: No. What I am referring to is the provision in the Bill to allow the job of commissioning to be outsourced to private companies. That has never been done before. It is there in the Bill and it is a big risk for the future.
	The Prime Minister made the NHS his most personal pledge before the election.

Andrew Lansley: Will the right hon. Gentleman just be clear to the House and get it accurate? The Bill sets out that commissioning consortia are statutory bodies covering the whole of the country in the public sector. Therefore, if they use private sector commissioning expertise—which the Bill does not require them to do—that is not commissioning responsibility. In the two years leading up to the election, primary care trusts increased their use of management consultancy by 80%, so they did use the private sector, whereas commissioning consortia do not have to.

John Healey: The point about the Health Secretary’s legislation is that it allows consortia to outsource in whole the job of, not the responsibility for, commissioning. He made the point that the consortia are public bodies, but they meet none of the standards of public governance. They can meet in private. As the right hon. Member for Charnwood (Mr Dorrell) has said, that serious job should be done by properly constituted and governed public authorities, but that is a loophole in the Bill.

Clive Efford: Like my right hon. Friend, I heard the Prime Minister and Deputy Prime Minister over the weekend say that there will be changes to the Bill. However, every Government Member who has intervened has defended the position in the Bill. Will we see changes as a result of pausing, listening and reflecting, or not? Will the Liberal Democrats have a spine tonight and vote with the Opposition to get changes to the Bill?

John Healey: My hon. Friend puts the position and the challenge, especially to the Lib Dems, very clearly. The challenge to Conservative Members is this: they must recognise that the Prime Minister made the NHS his most personal pledge before the election. People wanted to believe him, but in just one year the NHS has become his biggest broken promise. My hon. Friend mentions the pause. In our Opposition motion in March, we urged the Government to
	“pause the progress of the legislation in order to re-think their plans”.—[Official Report, 16 March 2011; Vol. 525, c. 374.]
	The Health Secretary dismissed that, but he has now been told to do so by the Prime Minister.
	However, many of the signs point to the Prime Minister’s “pause to listen” being a sham. Just one week after the announcement, and in fact on the day that the Health Secretary received that historic vote of no confidence at the Royal College of Nursing, the NHS chief executive wrote to NHS managers to tell them that
	“we need to continue to take reasonable steps to prepare for implementation and maintain momentum on the ground”.
	The House is used to pre-legislative scrutiny, but not pre-legislative implementation.

Ben Bradshaw: My right hon. Friend is absolutely right. Do we not face the worst of both worlds? The Government appear to be saying that GP consortia should be voluntary rather than compulsory, but primary care trusts are being abolished, and in some cases have been already. If that pause is serious, the Government need to stop that dismantling of the NHS and go back to the drawing board.

John Healey: My right hon. Friend is absolutely right, and he draws on his experience as a former Health Minister. While implementation continues apace, there is a so-called pause in the legislation. His point is exactly the one made by the all-party, Tory-led Health Committee in a recent report. If the Prime Minister wants to prove to NHS patients and staff that his pause is not just spin, he must shelve the Bill and make radical changes to his NHS reorganisation plans.

John Baron: The shadow Secretary of State speaks as if no reform is needed. However, given that our cancer survival rates are well below the European average and that that costs thousands of lives in this country, does he accept that reform of how the NHS treats cancer patients is necessary?

John Healey: The hon. Gentleman has great expertise in, and commitment to, cancer care. He is right that our survival rates continue to lag behind those of parts of Europe, but I am sure he is aware that the rate of fall in deaths from cancer has accelerated in the past decade. On that basis, and with continued investment and reform, we have a chance of catching up to European levels. However, the reforms proposed in the Bill, as many cancer charities and those who represent patients testify, raise the concern that the great gains made by the cancer networks in integrating and co-ordinating services for cancer patients and sufferers will be put at risk.

Several hon. Members: rose —

John Healey: I am going to make progress now.
	The NHS chief executive described the NHS reorganisation as
	“enormous—beyond anything anybody from the public or private sector has witnessed”.
	He is right. At this time of tight finances, the Government are piling on extra pressure and putting the NHS at risk with this reorganisation. The Health Committee warned in January that the NHS efficiency challenge was
	“already a high-risk strategy and the White Paper increased the level of risk considerably”.
	Now nearly £2 billion that was promised for patient care is being held back to cover the cost of reorganisation, and hospitals are being forced to cut back on costs by one third over the next five years, as all are forced into foundation status by 2014.
	I was in Wigan this morning, where the chief executive of the hospital trust told me that the hospital must make £14 million in cost savings this year and similar
	amounts the following year. He described that as an almost impossible task. More importantly, however, it puts at risk the strategy for better services and better value for money, and the strategy for more integration of hospital and community services. He said of the Government’s plans that the sheer distraction of reorganisation and insistence on competition will scupper our chance of doing that.
	The pressures of this high-risk reorganisation are one the reasons that, just one year into this Government, patients are starting to see the NHS go backwards again under the Tories, with waiting times rising, operations delayed, services cut back and front-line jobs lost. This is not just a problem with the timing or pace of change, however, and nor is it a problem of presentation. In fact, the closer people look at the plans, the more concerned they become, which is why there is growing criticism of the Tory plans for the NHS from doctors, nurses, patients’ groups, NHS experts, the Health Select Committee, peers in all parts of the House of Lords and now even the Lib Dem leader. The closer people look, the more fundamental and far-reaching they see these changes to be.
	Today, the Royal College of General Practitioners warned the Prime Minister that his health Bill undermines our comprehensive health care system and will cause “irreparable damage” to the core values of the NHS. So far Ministers have branded such criticisms as scaremongering, but people in the NHS are already starting to see this happen. The Government’s first act was to remove national waiting time standards—the patients’ guarantee that they would be seen and treated quickly—which the Health Secretary described as “clinically unjustified targets”, but the patients do not see it that way, and nor do the surgeons. The president of the British Orthopaedic Association described the delays now being faced by patients as “devastating and cruel”.
	The NHS Bill takes the break-up of our NHS still further. National Institute for Health and Clinical Excellence decisions on what drugs or treatments patients should have on the NHS become optional for commissioning consortia, and for the first time since 1948 the Secretary of State will not be responsible for delivering a national health service or for defining its scope. In future, the power to decide what health services will be provided free at the point of need—as now—and what further services will be charged for will rest with the new commissioning consortia. That was the basis of the concern expressed today by the Royal College of General Practitioners. These consortia will be able to meet and take decisions in private, and to outsource commissioning to private companies; but they will not even need to have a GP on their board—in fact, they will not need to have a board at all.

Nadhim Zahawi: The right hon. Gentleman mentioned the Royal College of General Practitioners. What does he think it makes of his policy, revealed in Pulse, to strip GPs of all financial responsibility?

John Healey: When the hon. Gentleman reads his next edition of Pulse, he will see my correction of that report, and note that the first five paragraphs were all reported and contained no quotes from me. He ought to know that after a survey by the British Medical
	Association found that more than half of doctors believed that they would spend less time with their patients as a result of these changes, the chairman of the BMA council, Dr Hamish Meldrum, said:
	“This survey shows that the government can no longer claim widespread support among doctors as justification for these flawed policies.”
	It is not the five clauses that set up the GP consortia that cause the most concern. It is the 85 clauses that set up the NHS as a full-scale market, and it is part 3 of the Bill, which opens up all areas of the NHS to private health companies; removes requirements for proper openness, scrutiny and accountability to the public and to Parliament; allows NHS hospitals to go bust and face a commercial insolvency scheme; places the judgment of the new competition regulator—just like those for gas and electricity—at the heart of decisions about the future of the NHS; and, for the first time, makes the NHS subject to the full force of UK and European competition law. That means that, in the long term, we will see clinical planning in the NHS being replaced by market competition, service integration being replaced by corporate cherry-picking, public accountability being replaced by commercial confidentiality and the public ethos at the very heart of our NHS being replaced by the profit motive.
	I agree with the Deputy Prime Minister that no Bill is better than a bad one, but I say to him that this is a bad Bill. That is why we have opposed it from the outset, and that is why we say that it must be shelved in its current form and that radical changes must be made. For us, for the NHS and for NHS patients, this is the test of the Prime Minister’s promise to protect the NHS. I commend the motion to the House. [ Interruption. ]

Mr Speaker: Order. The Prime Minister’s Parliamentary Private Secretary should be setting a good example to others. I call the Secretary of State for Health.

Andrew Lansley: The right hon. Member for Wentworth and Dearne (John Healey) has not only presented a weak motion to the House but managed to make a weak speech in support of it. The motion is completely silent about the problems that the NHS faced when we came to office. It is completely ignorant of the challenges that the NHS faces, and completely devoid of any recognition of the ongoing efforts of NHS staff to offer the very best standards of patient care, day in and day out. I am happy to make it clear, however, that I support the staff of the NHS every day, as we all must. I am not interested in a motion that ignores that; I am interested in supporting NHS staff to deliver the best possible care for patients.
	This debate is supposed to be about the future of the NHS, but the right hon. Gentleman had nothing to say about its future. He wanted to talk only about politics and the Health and Social Care Bill. What happens in the NHS every day is not the same as the content of the Bill, important though that is; it is about quality of care and the outcomes that are being achieved for patients. I will ask the House to reject the motion, because I intend to use the debate to be positive and to show how we will give the NHS a stronger future.

Toby Perkins: I am glad to hear that the Secretary of State supports the staff of the NHS, but is it not the truth that the staff of the NHS do not support him?

Andrew Lansley: That is complete nonsense. This is not about me: it is about what the staff of the NHS want. They want the ability to be able to deliver care for patients without being told what to do by the top-down bureaucracy and targets of the Labour Government. They want the ability to deliver the care that patients need, to join up health and social care and to integrate the pathways of care. Our Bill is about giving them the structure that will allow them to do that. They want every penny that we as taxpayers provide to the NHS to get into the hands of front-line staff, and for the absolute minimum to go in waste and inefficiency. That is what they want, and that is not about me, it is about them.
	A stronger NHS will require change, so that it no longer spends £5 billion a year on bureaucracy.

Dave Watts: rose—

Andrew Lansley: Perhaps the hon. Gentleman will explain why all that money was being spent on bureaucracy.

Dave Watts: Given that today and on previous occasions the Secretary of State has claimed that the Government are not trying to privatise our hospitals, will he publish all the documents that have passed between his Department and my NHS trust, because they will demonstrate that that is exactly what he intends to do? He intends to try to privatise my hospital.

Andrew Lansley: The hon. Gentleman will know, because the Minister of State, my right hon. Friend the Member for Chelmsford (Mr Burns) has told him in the past, that when NHS trusts are moving to foundation trust status, there will be an agreement, but it is not about privatisation. When the hon. Gentleman’s party was in government, it said that the only way Hinchingbrooke NHS trust could turn its management around was for it to be prepared to look for the best possible management. That is the extent of what we are talking about, and it was done under his Government.
	This will require change. We are not going to spend £5 billion on bureaucracy. We are not going to let the number of managers double in future as it did under Labour, and we are not going to let the number of managers increase six times as fast as the number of nurses. Since the general election, we have 3,500 fewer managers and, as a consequence, 2,500 more doctors and 200 more nurses.

Louise Ellman: On 19 March, the interim chief executive of Monitor said that under this Bill, doctors talking to providers about health care would be the same as Marks & Spencer talking to their suppliers about which brand of washing powder to buy. Is that the Health Secretary’s vision for the future of the national health service?

Andrew Lansley: No, not at all, and I do not believe that Monitor believes that either. The hon. Lady can see that the proposal in the Bill is clear. It was the Labour Government who established Monitor as a regulator
	and who introduced competition into the NHS. The Labour Government did all those things, but Monitor’s job is not to impose competition rules but to deliver what is in the best interest of patients.

Graham Stuart: The shadow Secretary of State is a decent man and an experienced Minister. The reason his speech was so weak is that he had no conviction because he has been forced by the union paymasters of the Labour party and of the shadow Leader of the Opposition to deliver the sort of speech previously given by the far left who inhabit the Benches way over there. My right hon. Friend should not listen to those voices; he should press ahead and make a difference for patients, not politicians.

Andrew Lansley: I agree with my hon. Friend that the shadow Health Secretary is a decent man, and at the turn of the year he quite decently expressed his support for the Bill’s principles and his understanding that it was consistent, coherent and comprehensive. It makes one wonder what happened to him in the interim. Did the trade unions—the paymasters of the Labour party—get to him and tell him that they did not like the idea that patients should be able to get the care they need or the idea that we should get resources into the front line rather than into the vested interests of the NHS?
	What we are going to do is put patient care at the heart of our reforms. We are not going to let hospital productivity continue to decline as it did over the last decade. Under Labour, we saw a 15% decline in productivity, yet we heard nothing from the shadow Health Secretary about that. It is this Government who are taking action to improve hospital performance by changing the way hospitals are paid to reward excellence—for example, by not paying for unnecessary readmissions of patients who are discharged too soon.

Jesse Norman: Hereford hospital is labouring under a very expensive private finance initiative contract. Does my right hon. Friend not think it a tragedy that the last Government cast good sense and good economics away, forcing so many hospitals into PFI?

Andrew Lansley: My hon. Friend makes an important point—that it was under the Labour Government that many of these projects were undertaken, and they are leaving an enormous bill in the NHS for future taxpayers and future NHS organisations to meet. A contract is a contract, as the right hon. Gentleman and the House will understand, and we inherited contracts from the Labour Government, many of which were very bad contracts, such as the ones on IT that we have had to renegotiate. Frankly, it is due to my right hon. and hon. Friends in the Treasury and ourselves at the Department of Health that people have been put into the Queen’s hospital in Romford to look at how we can resolve some of these PFI problems and reduce those costs. We need to increase productivity in the NHS and cut out much of the waste in it.
	It is us who will usher a new era of transparency into the NHS, shedding light on those areas that the previous Administration sought to cover up. Before the election,
	how often were patients having to go into mixed-sex accommodation when the rules on single-sex accommodation were breached? We did not know, because when Labour Members were in government they would not tell us. Since we started publishing the data in December, the number of patients put into mixed-sex accommodation without justification has halved.

Pat McFadden: The Secretary of State talks of service to patients. Does he accept that the amount of time for which patients must wait for treatment is extremely important to them? Does he also accept that the number of people waiting more than four hours to be treated in accident and emergency departments is at its highest for six years, and that the number of people waiting more than 18 weeks for non-urgent operations is at its highest for three years?
	The Secretary of State attacks our targets, describing them as “top-down bureaucracy”. Does he not accept that they are actually a guarantee that people who cannot afford to go private and pay will not have to wait in pain, but will be treated within a reasonable time frame?

Andrew Lansley: I do not accept the right hon. Gentleman’s premise. Waiting times in the NHS are stable. We had a conversation about that during the last session of Health questions, but perhaps the right hon. Gentleman was not in the Chamber and did not hear it. The average waiting time is nine weeks. The operational standard requires 90% of admitted patients to be seen within 18 weeks—that is in the NHS constitution—and it has been maintained, although the figure was 89.9% in February after a winter during which critical care beds were full because of flu.
	The right hon. Member for Wentworth and Dearne talked of four-hour waits in A and E as if the fact that a patient had been discharged within four hours were the only issue. He should go and talk to the families of patients who, in the past, were discharged from the emergency department at Stafford general hospital and left to die.
	What matters is how long it is before a patient is seen by a qualified professional, and how long it is before that patient is treated. What about those who leave without being seen? What about those who are not given the care that they need, and have to return to the emergency department? Those are the things that matter to patients, and those are the things that are now part of the accident and emergency quality indicators which, this April, we said that we would publish for the first time. It is we who are focusing on services for patients. Labour Members had 13 years to look at what really mattered to patients and at the real quality of what was delivered to patients, but they did not do it, and we are going to do it.

Nadhim Zahawi: Pausing and listening and getting the detail right are about grown-up politics. Opportunism and flip-flopping are about the Opposition.

Andrew Lansley: My hon. Friend is absolutely right.

Several hon. Members: rose —

Andrew Lansley: I give way to my hon. Friend the Member for Gainsborough (Mr Leigh), the former Chairman of the Public Accounts Committee.

Edward Leigh: Sadly, despite massive increases in funding over 15 years, there has been an undoubted catastrophic decline in NHS productivity. Does my right hon. Friend accept that many of us on the Government Benches feel that if we are to save the NHS there is no alternative to more co-operation with the private sector, and that he should stick to his guns?

Andrew Lansley: My right hon. Friend made that point when he chaired the Public Accounts Committee, and it should silence Labour Members, because the Public Accounts Committee has said exactly the same thing since the election under the chairmanship of the right hon. Member for Barking (Margaret Hodge)—that productivity in the NHS declined consistently under Labour.
	Let me make clear that if we are going to make—[Interruption.]

Mr Speaker: Order. The House is in a very excitable state. The issues are of the highest importance and they provoke strong feelings, but the debate must be conducted in an orderly way, and the Secretary of State is entitled to a decent hearing.

Andrew Lansley: Thank you, Mr Speaker.
	I remember Labour’s scaremongering during the election about cancer waits, for example, but in 13 years in government they never actually looked at cancer survival rates. They never looked at the results for patients. It took this Government to publish the first outcomes strategy for cancer, which made clear that what matters to patients—

Several hon. Members: rose —

Andrew Lansley: I will give way in a moment. That strategy made it clear that what matters to patients is not only how quickly they see a consultant, but whether they survive.

Ben Bradshaw: If things were so terrible under the Labour Government, why was public satisfaction with the NHS at record levels when we left office, and why were waiting times at record lows? Both are now going in the wrong direction. Will the Secretary of State please tell us—we have not yet received an answer to this question—what will happen in those areas now that GP consortia are to be voluntary? He has already abolished the primary care trusts, so who will be responsible?

Andrew Lansley: It was also a period during which complaints to the NHS reached their highest ever levels. If we ask the public who they think are best placed to design the services patients need, we will find that the answer is their general practitioners, hospital doctors and nurses, not politicians on either the Government or the Opposition Benches. This is about doctors and nurses being in charge, not politicians.
	It took this Government to focus on cancer outcomes. It took this Government to provide the drugs patients need through the cancer drugs fund. Under Labour, patients went without new cancer medicines that patients in every other European country were getting access to. It is this Government who are investing in more diagnostic equipment, and more screening and early diagnosis, so that we get better outcomes.

Angela Smith: I must say that I admire the consistency with which the Secretary of State defends his proposed legislation. However, will he tell us what he plans to concede, given the threatened veto by the Deputy Prime Minister and the Liberal Democrats?

Andrew Lansley: I do not want to correct the hon. Lady, but everything I have been saying up until now has been about defending the NHS and defending our focus on delivering better results by giving the NHS greater front-line devolved responsibility. That is not a matter of debate and disagreement between the coalition parties; we are all in favour of that. The point is this: how can the Bill best support the principles on which we are agreed? I thought the right hon. Member for Wentworth and Dearne and the Labour party were agreed on those principles; that seemed to come out from his interview last week. Indeed, at the end of his speech today I was not quite sure whether or not he agreed with us.

John Baron: Given that our cancer outcomes are well below the European average, the need for NHS reform is well established. However, as my right hon. Friend the Secretary of State will know from my having raised the issue with him previously, the entire cancer community will breathe a sigh of relief if the guaranteed funding for cancer networks can be extended to 2014 when the transition period for GP commissioning comes to an end, as we would risk losing a lot of expertise if we were to end it in 2012. Will he address that point?

Andrew Lansley: The support for cancer networks will continue during the course of this year and the start of next year, but when the NHS commissioning board takes responsibility for commissioning, including the relationship with consortia, it will need to decide how to manage its commissioning responsibilities. However, as I have told my hon. Friend in the House previously, it is now looking—we will look at this over the coming months—at how it can use networks as a basis for having precisely the kind of commissioning structures we want, and it is my expectation that that would include cancer networks that are not only helpful for providers, but that tie together commissioners and providers in understanding the future strategy for cancer.

Charlie Elphicke: Will my right hon. Friend give way?

Andrew Lansley: If my hon. Friend will forgive me, I will give way again a little later, but first I want to make a couple of further points.
	The House knows of my commitment to the NHS; Opposition Members know of that, too. They know that I have not spent seven and a half years as shadow Secretary and Secretary of State to see the NHS undermined, fragmented or privatised. They know that
	that was never my intention; it is not my intention. Before the last election, we were absolutely clear that we would protect the NHS, but we are doing more than just protecting it; we are strengthening it. We are enabling clinicians to lead a more integrated, responsive, accountable NHS—not fragmented, not privatised, not based on access to insurance, and not compromising quality for price—and, equally, an NHS that is not run by a top-down, unaccountable bureaucracy, but that is locally led and locally accountable.
	As the right hon. Member for Wentworth and Dearne admitted, this is a comprehensive, consistent and coherent vision, and it is an evolution of the better policies of the last 20 years. It was the last Labour Government who introduced patient choice; we will extend it and give patients the information they need to make it work. It was the last Labour Government who introduced practice-based commissioning; we will make it real, with health professionals designing integrated pathways of care with decision-making responsibilities. It was the last Labour Government who introduced foundation trusts; we will deliver on their broken promise to take all NHS trusts to foundation status. It was the last Labour Government who introduced payment by results, but left it half baked, distorting services and hindering joined-up care; we will change it so that it genuinely supports the best care for patients. Of course, it was the last Labour Government who brought the independent sector and competition into the NHS, but we will not follow their lead by giving the independent and private sector providers the opportunity to cherry-pick services and by giving them financial advantages over NHS providers.

Gordon Birtwistle: Will the Secretary of State confirm that the meeting patients needs programme put forward by the previous Government, which closed down many accident and emergency units and many children’s wards, will not happen again under this new regime? Will he confirm that that is because local people and local GPs will be consulted first, as opposed to having the programme driven through with no support and no consultation, as under the previous Government?

Andrew Lansley: I completely understand and agree with my hon. Friend. I thought it was outrageous for the shadow Secretary of State to say, “Oh, they promised a moratorium and now some closures are taking place.” Why? Because we were left what were, in effect, faits accomplis by the previous Government and it was impossible to change them. [Interruption.] My hon. Friend the Member for Maidstone and The Weald (Mrs Grant) would feel the same as my hon. Friend the Member for Burnley (Gordon Birtwistle).

Andrew George: I can confirm that we agree on the issue of principle and that I am not questioning the Secretary of State’s personal commitment. The issue remains one mentioned in the motion: the extent to which the policy in the Health and Social Care Bill is not just another top-down reorganisation of the sort that the coalition Government said they would stop and the extent to which the policy being driven through Parliament, on which a listening exercise is taking place,
	delivers what is in the coalition agreement. The debate is about the extent to which the Bill reflects the coalition programme agreement.

Andrew Lansley: My hon. Friend will know that the coalition agreement supports, in essence, all the principles of the Bill, with the exception of the specific consequence of the abolition of the strategic health authorities and primary care trusts. As with the whole of the Bill and its related measures, that proposal was the subject of collective agreement and it flows directly from the belief, shared not least by him and his Liberal Democrat colleagues, that we need much stronger local democratic accountability in the NHS. We are constructing health and wellbeing boards as an integral part of local authorities, and he will know that the overwhelming majority of local authorities which have volunteered to be early implementers of that approach believe precisely that democratic accountability is an essential part of the future of the NHS.

Several hon. Members: rose —

Andrew Lansley: Let me just make some progress. We need this modernisation for the NHS because of the challenges it faces in the future. We need to deliver £20 billion of efficiencies over the next four years. I remind the House that that requirement was set out originally under a Labour Government in 2009 without the merest hint of irony—I say that given that they created the inefficiencies in the first place. Today, I can give the House some figures that the Labour party would wish that people did not know. If Labour’s spending plans for the NHS at the last election had been implemented over this spending review period, the NHS budget would have been cut by £30 billion compared with what we have put into the NHS over the spending review period. So let the right hon. Member for Wentworth and Dearne get up now and explain: how was the NHS going to deal with £20 billion of efficiencies while he was cutting £30 billion out of it, instead of it getting the extra £11.5 billion it is getting from taxpayers through this coalition Government?

John Healey: After 20 minutes of the Health Secretary’s speech, the hon. Member for St Ives (Andrew George) finally brought him to his own plans and he was clearly very uncomfortable. What does he say when the Prime Minister wonders how he got the Government into such a mess over his plans? What does he think of the chair of Monitor’s observation that the approach being taken is a combination of
	“previously unannounced policies, a complete failure to build the necessary political and professional consensus and an apparent disdain for the detailed planning of implementation”?
	That was said by one of the Government’s allies.

Andrew Lansley: I suppose the one thing the right hon. Gentleman has learned about being in opposition is that it is best for a party to try to forget everything that it did in government, because it will not be held to account for it. He has also recognised that the best thing is to have no ideas of his own. He does not even seem to know whether he agrees with our ideas or opposes them. We do not have any answers from him. The right hon. Gentleman’s quotation was from the former, not current, chair of Monitor, who knows perfectly well
	that these measures were in our respective manifestos and were brought together in the coalition agreement. They have a mandate. From my point of view, this is not just about the electoral mandate but about how we can deliver the best care for patients and see through principles that I thought the right hon. Gentleman’s party, as well as ours, believed were right.
	Let me make it clear that the challenges in the NHS are about more than just clearing up Labour’s mess. We must recognise that there are now more pensioners than children under 16, alcohol-related admissions to hospital have doubled and emergency admissions have risen by 12% in just four years. Obesity in this country has doubled in the last 25 years. Under Labour, the demand for health care was rising while productivity was falling. The only way that Labour could cover those risks was by massively increasing the budget and that is no longer an option. Mounting pressure on the NHS is inevitable and the status quo, as Labour recognises, is not an option. The NHS needs modernisation.

Nadine Dorries: Will the Secretary of State give us an update on the tally of the number of GPs who have signed up to the new consortia to support the NHS reforms?

Andrew Lansley: Yes, I will. Some 220 pathfinder consortia have come forward, representing the equivalent of 45 million patients across England—that is, 90% of the population. They are not obliged to do so. They have volunteered to come forward to demonstrate that they can deliver better services for patients.

Several hon. Members: rose —

Andrew Lansley: Let me explain—[ Interruption. ]

Mr Speaker: Order. I am going to try to be helpful to the hon. Member for Easington (Grahame M. Morris). When a Minister gives no indication of giving way, a Member must not simply stay on his or her feet. The situation is clear: the Secretary of State is not giving way at the moment. Once again, I appeal for the restoration of some sort of calm. The Secretary of State should be heard with a degree of civility—[ Interruption. ] Order. I ask Members to reflect on how our proceedings are regarded by members of the public whose support we sought not that long ago.

Andrew Lansley: Thank you, Mr Speaker.
	The principles we are pursuing are simply stated as
	“a greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes”.
	The right hon. Member for Wentworth and Dearne will no doubt recognise those words, because they are his own from January, when he said that he supported the general aims of our reform.
	We are already delivering on our vision. We are extending patient choice and involving patients more in decisions about their care. We are cutting back Labour’s waste and reducing the bureaucracy that stifles and undermines doctors and nurses. We are putting clinicians at the heart of commissioning, with almost 90% of the country now covered by new pathfinder consortia.
	We are driving down hospital-acquired infections, sustaining and improving the performance of the NHS, stopping Labour’s arbitrary box-ticking and focusing on the outcomes that matter. We have a world-leading framework for the results that matter to patients: reducing avoidable mortality; enhancing recovery after treatment; improving quality of life for those with chronic conditions; maximising safety and cutting the number of infections; and continually improving patients’ experience of their health care. Those are the outcomes for which we and the NHS will be accountable.
	Let me be clear: there will be substantive changes to the Bill to deliver improvements for patients. There is only one issue for me, however: will it deliver better care for patients? That is why we will pursue NHS modernisation and why we will stick to our principles. It is why we are listening to improve the Bill. That is what the coalition Government are committed to. Today, led by the NHS future forum, we are engaging with the health service and beyond to ensure that the legislation delivers on those principles.
	Unlike the Labour party, which has retreated to its union-dominated, regressive past, we will not retreat. We will be progressive with those principles. Just last week, the right hon. Gentleman called for a return to Labour’s top-down targets and for GPs to be stripped of all their financial responsibility. He has called for the NHS to be run by a bureaucracy, not by doctors and nurses. Critics of the Bill must answer this question: if they do not want patients, doctors and nurses to be in charge of the NHS, then who do they want to be in charge?
	The right hon. Gentleman has turned his back on two decades of NHS modernisation. We will never accept the Labour party’s prescriptive, top-down bureaucracy or its waste. We did not accept Labour’s plan, which would have meant taking £30 billion out of the NHS in England over this Parliament and we will not follow the route that the Labour party in Wales has taken, where it is cutting the NHS. Instead, we are increasing the NHS budget over this Parliament by £11.5 billion. We will equip the NHS to deliver better and improving services by using more resources more effectively. We will empower patients with information and with choice. We will empower doctors and nurses to shape services for their patients. We will bring together the NHS, public health and social care in a combined local strategy. We will make the NHS genuinely locally led, while meeting national standards. We will focus relentlessly on the quality and outcomes we achieve for patients. We will protect the NHS and strengthen it. We will do that not by living in the past, but by modernising for the future. We want a modern service that is true to its core values. The Labour party’s motion offers no future for the NHS. We on the Government side will give the NHS a stronger future, and I urge the House to reject the Labour party’s motion.

Several hon. Members: rose —

Mr Speaker: Order. There is extensive interest in speaking in this debate, as a result of which I have imposed a seven-minute limit on each Back-Bench contribution.

Dan Jarvis: The national health service is about people—those who work in the NHS and the patients for whom they care. It produces
	heroes on a daily basis. In the last year, I spent long nights at my late wife’s bedside as she battled against cancer. I am reminded of Andrew Agombar, the consultant surgeon who twice operated on my late wife, and of his relentless commitment to trying to save her and to serving the public. I am reminded of the conversations I have had in Barnsley hospital with doctors and nurses. I am reminded of the GPs who provide an integral part of the British way of life and I am reminded of the porters, cleaners and volunteers. They are all heroes and are all dedicated to the very best principles of our NHS.
	In my family’s darkest days, we saw the true genius of the NHS—a genius based on care and compassion, commitment and dedication, principles and standards. The market can be a useful tool, but there are limits to its ability to deliver those values. There is a reason why Bupa does not do accident and emergency, and we must never allow an ideological free-market agenda to undermine all that is great about the NHS. That is what the Government are in danger of doing. I accept the need for fiscal responsibility and I acknowledge that the Secretary of State’s proposals have the purpose of moving health care more into the community and away from hospitals, but the patient, not the market, must always come first. The risk is that the British people will pay for these reforms three times over while patients see little or no improvement in their care.
	The previous Labour Government delivered the biggest hospital-building programme in NHS history based on private finance initiative funding, which the then Opposition supported. Consequently, many trusts are now locked into 20 to 30-year fiscal plans. In order to realise the benefits of the investment that Labour put into the NHS, those trusts will require stable funding over this period. Without it, much of the existing investment could be wasted.
	GP commissioning is another example of the Bill’s inefficiencies. The taxpayer could end up paying to fund the community or the private investor.

Ben Gummer: The hon. Gentleman has just given an eloquent explanation of why the market should be ignored in health care, but he has also said that the whole of health care spending should be fixed in stone for 30 years just to suit the PFI contracts signed by the previous Government.

Dan Jarvis: I did not say the market should be ignored. The point that I was making is that ultimately it is a matter of priorities.
	What will be the cost of making NHS staff redundant, before the additional cost of rehiring by the GP commissioning bodies? To me, none of this makes sense, and it leads many health officials to question whether the Health Secretary fully understands what impact the reforms will have on the front line morally, economically and logistically, and in this confusion the NHS is placed at risk.
	Why not use the facilities that the Labour Government spent £100 billion building over the past decade? Would it not be simpler to keep the PCTs? Surely it makes far more sense to increase GP involvement to allow for clinical oversight, and use the facilities and the staff base that we have spent the past decade investing in. Of
	course there are problems in the NHS which need solving, but the Government’s plans are not just a misguided attempt at privatisation by stealth; they fail to acknowledge that the past 13 years of reforms ever happened.
	As well as issues of cost, the proposed reforms are a threat to the accountability of the NHS—at a local level, with the removal of the non-executive directors, and nationally, with the transfer of responsibility from Whitehall to the NHS board. How will we know whether we are getting value for money? What impact will the reforms have on local waiting times? If the Secretary of State genuinely believes in these reforms, what accountability mechanism is he introducing to judge how well they are working? The Department of Health has not explained how the reforms will address the challenges of longer life expectancy, advances in technology and greater public expectations.

Graham Stuart: I am grateful to the hon. Gentleman, who is making a thoughtful speech. The incoming Government inherited an NHS which has had a massive increase in expenditure, yet has seen a 15% drop in productivity over time. Does he have any thoughts on what reforms do need to be made? Despite having money thrown at it, the NHS was not delivering in terms of productivity and was thereby letting patients down. What is his prescription to make the NHS stronger?

Dan Jarvis: Although I am new to this business, if hon. Members and the Secretary of State had such faith in the reforms, it is confusing to me why they were not put in the manifesto and the people of this country given the opportunity to vote on them at the general election.
	GPs will be substituting the calculator for the stethoscope. That is bad for the NHS and bad for patients. Given how far we have come, would not the first year of the Secretary of State’s tenure in the Department of Health have been better spent, for example, on a concentrated investment of effort in cancer care? We must fight the war on bureaucracy, but not at the expense of the war on cancer.
	Would not the Secretary of State have better spent his time learning from our European partners how to educate our constituents about the dangers of an unhealthy lifestyle—diet, drink and drugs—and their effect, particularly with regard to cancer treatment? We need to address why a cancer sufferer in Barnsley is less likely to survive than a sufferer in Barnet. These are the NHS reforms that would make a positive difference and that the country expects us to deliver. Instead, in my constituency, the scale and pace of the Government’s cuts are making it virtually impossible for Barnsley hospital to plan ahead. Budgets are being cut while patient numbers are going up.
	The Government are proposing the biggest reorganisation of the NHS since its inception—

John Pugh: rose —

Dan Jarvis: I have almost finished so I shall keep going.
	The reorganisation is one for which the Government have no mandate. That raises the question, as I said, of whether the Secretary of State deliberately chose not to
	include these drastic reforms in the manifesto because he knew how unpopular they would be. The NHS is the pride of its staff, its patients and our country. We all deserve better.

Stephen Dorrell: I do not agree with everything that the hon. Member for Barnsley Central (Dan Jarvis) has just said, but I congratulate him on a thoughtful speech and wish to pick up on two points with which I entirely agree. The first was his moving tribute to the NHS staff who provided the care for his late wife. The second point, which is of immediate concern to us, was his recognition that the health service, like all human institutions, must embrace the need for change.
	The question before the House this afternoon is how we can ensure that the need for change that the health service faces can be embraced and made a force for good. I open my remarks on that point by agreeing with the shadow Health Secretary, who said only a few short months ago, on 20 January —his words have already been quoted to him—that
	“these plans are consistent, coherent and comprehensive. I would expect nothing less from Andrew Lansley”
	Nor would I. I agree that that is a fair description of my right hon. Friend the Secretary of State’s proposals. I particularly congratulate my right hon. Friend, and the Government at large, on the fact that, despite that being a fair description of their proposals, they are now engaged in a listening exercise, the purpose of which is to improve a set of proposals that were described by the shadow Health Secretary in the terms I have already quoted.
	I particularly welcome the fact that my right hon. Friend and the Prime Minister have made it clear that this will be a listening exercise on the policy substance, not just a process of balancing political forces in order to cobble together a compromise. If we are to be true to our commitment to the health service, as my right hon. Friend is, we need to ensure that we focus on the problems it faces and put in place structures that will deliver solutions.

Mary Macleod: Does my right hon. Friend agree that the Prime Minister has not broken any promises on the NHS, as the shadow Health Secretary has suggested, and that the Government are investing in the NHS and there is no question of privatising it?

Stephen Dorrell: I entirely agree with my hon. Friend. The Prime Minister and the Secretary of State made clear during the listening exercise their determination to ensure that proposals are brought forward that improve the capacity of the structures of the health service to deliver the objectives my hon. Friend has just articulated.

Emma Reynolds: Will the right hon. Gentleman give way?

Stephen Dorrell: I will give way once more and will then have to make progress, because I have very limited time.

Emma Reynolds: Does the right hon. Gentleman agree that it would have been possible to make the current structures work better? The coalition agreement states, on page 24:
	“We will ensure that there is a stronger voice for patients locally through directly elected individuals on the boards of their local primary care trust”.
	It is possible better to democratise the PCTs and give greater clinician involvement in them, so does he support some of the calls from the professionals to keep the cluster PCTs?

Stephen Dorrell: I want to make my speech in my own way. The hon. Lady asked at the beginning of her intervention whether I agree that it would have been possible to introduce quite a lot of this without the need for a long Bill. She does not need to put that question to me, because the Health Secretary made the same point during the last health questions. We are seeking in the Bill to provide a holistic basis—a structure for the health service going forward, and that is an objective, starting from where we are, that it seems entirely reasonable to embrace.
	I was seeking to identify the problem that my right hon. Friend’s measures must be designed to tackle, because as he and the Prime Minister have said repeatedly, no change is not an option. That should not be a matter of party political debate because the definition of the core problem facing the health service can be found in the NHS annual report for 2008-09, which was published 12 full months before the general election. I quote from it a single sentence:
	“We should also plan on the assumption that we will need to release unprecedented levels of efficiency savings between 2011 and 2014—between £15 billion and £20 billion across the service over those three years.”
	That is what we on the Health Committee referred to as the Nicholson challenge, because it was first articulated in the chief executive’s report a full 12 months before the election. That is the challenge that my right hon. Friend has to address, because it is the inescapable challenge in front of the national health service.
	In point of fact, my right hon. Friend has made the challenge rather easier than it was in the days of the previous Labour Government, because there is a commitment to real-terms growth in the health budget throughout this Parliament, and because he has given the health service four years to respond to the Nicholson challenge, whereas the original articulation was focused on the three years ending in 2014.
	But the substance of the need to deliver unprecedented efficiency gains out of the health service is the constant between the previous Government and the current Government. The articulation of it in the chief executive’s report was “£15 billion to £20 billion”; I have always preferred to articulate it as, “4% efficiency gain, four years running”.
	That is what the health service has to deliver against the background of it never having delivered 4% efficiency in a single year, and of no health care system anywhere in the world having delivered a 4% efficiency gain, four years running. So, Sir David Nicholson, 12 months before the general election, was 100% right to say, “This is an unprecedented challenge,” and the challenge was embraced by the previous and current Governments.

Grahame Morris: Will the right hon. Gentleman give way?

Stephen Dorrell: Will the hon. Gentleman forgive me? I want to cover what I regard as important ground.
	I have expressed the challenge as an efficiency target, but the same target can be looked at differently, and it is important for the House to understand that this is a matter not just of dry health economics, but of the way in which the health service delivers clinical care, because so often in such debates we imagine that the normal health service patient is a normally healthy person who goes to see the GP and is referred for an elective acute procedure. It is as well to remember, however, that such patients constitute 11% of NHS expenditure, and sometimes I wish that we would devote the same attention to the remaining 89%, because that includes emergency patients, with 75% being expenditure on patients with long-term complex conditions, most of whose care would be better delivered by integrated services in the community.
	The challenge that we ought to address when we think about the future of the health service involves not just another discussion about bureaucratic structures, but how we deliver the change in the service’s clinical model to ensure that it delivers efficient and high-quality care to the patients who present for care, rather than to the patients as so often described in the policy pamphlets.
	That is why it is so important that the structures that emerge from this listening exercise achieve more radical integration than we have yet achieved in the health service—of primary care, community care and social care. It is why the GPs have to be engaged in the process. Once again, that is not a matter of party political debate; the point is made in all the world-class commissioning documents that I do not have time to quote.
	My message for the House is that this is an intensely depressing debate, because it is as if the past 20 years never happened. The reality, when we look through the torrent of rhetoric, is that this policy is not a great break from the past; it is a desire on the part of my right hon. Friend to take ideas that were expressed and pushed through by Labour Ministers between 1997 and 2010, and to seek to make them effective in the context of the challenge that I have defined.

Grahame Morris: I pay tribute to the thoughtful contribution by the right hon. Member for Charnwood (Mr Dorrell), who chairs the Select Committee on Health.
	I come to this debate as, I believe, one of the longest-standing opponents of the Bill, both as a member of the Health Committee and as a member of the Health and Social Care Bill Committee. As such, I have consistently raised serious concerns about not only some of the detail contained in the Bill but the direction of travel charted by these reforms since they have developed from manifesto to coalition agreement to White Paper, and finally morphed into the Bill itself. I have become accustomed to the protestations and rebuttals of Health Ministers on every issue that I have raised, so I am somewhat sceptical about the listening exercise.
	Those issues include the pace and scale of reform, the lack of a credible large-scale pilot to assess the impact of the changes, the conflicts of interest inherent throughout
	the Bill, as identified in the Channel 4 “Dispatches” TV documentary, and the threat of privatisation by stealth.
	[
	Interruption.
	]
	Despite the protestations and groans of Government Members, there is nothing in the Bill to rule that out. I can cite some examples, not least in relation to the prison health contract that was recently awarded to Care UK to provide health services for eight prisons in the north-east of England, resulting in 120 NHS staff being displaced and made redundant. There is a clear and present danger of privatisation of the service.
	Perhaps the strongest advocate of the Bill, as it stands prior to any changes, has been the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who is no longer in his seat, and who was the Lib Dem steward of the Bill in Committee. On 10 March, he said in an interview in The Guardian:
	“This is a change that liberals can embrace.”
	On 17 November, in the Commons Chamber, he called Labour’s record on the NHS a “failed status quo” and wholeheartedly backed the Tory NHS reforms. This year, we found out that the Department of Health had at that time been trying to suppress an internal Ipsos MORI poll of public satisfaction with the NHS. That is interesting, because the poll shows record levels of public satisfaction. Perhaps even more disturbing are rumours that next year the Department intends to cancel the commissioning of such a survey. Rather than saying that Labour has failed on the NHS, the survey showed the highest ever levels of public satisfaction.
	An even bigger supporter of the Bill, until now, has been the Deputy Prime Minister. On 23 January this year, on the “Andrew Marr Show” he was asked by Mr Marr, of the Health and Social Care Bill,
	“Was that in the Liberal Democrat manifesto?”
	The Deputy Prime Minister responded:
	“Actually funnily enough it was. Indeed it was…I agree it’s an ambitious programme of reform—but over time I think it’ll leave patients with the feeling that they are at the centre of it.”
	I am slightly perplexed by the hasty posturing and sudden synthetic explosion of anger by senior Liberal Democrats in the coalition, perhaps in the wake of the meltdown following last Thursday’s elections. I take those criticisms with a pinch of salt.

Tony Baldry: The hon. Gentleman is a member of the Health Committee, so one would expect him to be well informed on these matters. I assume that he reads other reports of the House relating to health. I wonder what he would say about the report of the Public Accounts Committee that was recently published, under the chairmanship of one of his right hon. Friends, which says:
	“The trend of falling NHS productivity will have to be reversed if the NHS is to deliver, by 2014-15, savings of up to £20 billion each year for reinvestment in healthcare.”
	The PAC found that there were serious problems with productivity—

Dawn Primarolo: Order. Interventions, by their nature, must be brief, particularly when so many Members are waiting to speak.

Grahame Morris: I am grateful, Madam Deputy Speaker.
	Indeed, that was the point that I wanted to make when the right hon. Member for Charnwood was speaking about the level of the challenge faced by the NHS. Sir David Nicholson rightly pointed out that major efficiency savings have to be made and he identified the figure. However, he did not advocate massive organisational change on top of the drive for efficiencies in the system.
	During the 28 sittings of the Public Bill Committee, I raised countless issues and made numerous interventions against the health reforms. Unfortunately, the Secretary of State was unwilling to take them earlier in this debate. I have followed this matter very closely. The hon. Member for Banbury (Tony Baldry) asked if I had read the Bill. As a matter of fact, I have read it inside out and could probably give some lessons to a few Members who are in the Chamber. My conclusion is that the policy has remained basically the same, and that only the public relations strategy and the spin has changed.

Chuka Umunna: Will my hon. Friend give way?

Grahame Morris: I will give way just one more time.

Chuka Umunna: My hon. Friend said that he sat on the Public Bill Committee and he is also a member of the Health Committee. Has any clarification been given during this reorganisation on the operation of the Transfer of Undertakings (Protection of Employment) Regulations 1981 and 2006 with regard to employees in the NHS?

Grahame Morris: That is a key point, and I know that whether TUPE will apply under the terms of the Bill is a legitimate concern of trade unions. However, I will leave it to the Minister to give a definitive response.
	My argument is that we need an end to the gesture politics and a radical shift in policy. The Conservatives’ rhetoric and that of their coalition partners must match the reality on the ground. If the opportunity to
	“pause, listen, reflect and improve”
	is the Health Secretary’s chance to engage with NHS staff, the 98% vote of no confidence against him by the Royal College of Nursing must have been a major hiccup.
	It seems to me that this week’s strategy is to let the Deputy Prime Minister flex his muscles. He said yesterday:
	“Protecting the NHS, rather than undermining it, is now my number-one priority.”
	Perhaps he can tell us what has changed since the White Paper was published in July last year. So far, we have heard that as a result of the listening exercise there may be tweaks to GP-led commissioning consortia to make them more inclusive and accountable, that scrutiny arrangements may be strengthened and that the pace of change from PCTs to GP consortia may be slowed. If that is all the Deputy Prime Minister can negotiate as No. 2 in the Government, it demonstrates, particularly to his own supporters, that he has prostituted his party and the NHS for a position in power.
	The Deputy Prime Minister must take heed of the lesson from the Royal College of General Practitioners:
	“Intensifying competition in the NHS will lead to the service breaking up, drive up costs, damage patient care, and mean less integration of services.”
	The future of the NHS requires him to put aside gesture politics and use his clout to force out the central privatising elements of the Bill; drop Monitor, the economic regulator of the health service; protect national pay terms and conditions for NHS staff; and limit the ability of private health care companies to enter the NHS at every level. He must ensure that the Government do not privatise the health budget, but bring GPs and other health professionals into PCTs to achieve clinical excellence in commissioning, without there being ulterior motives for private profit.
	I know that time is short and that many Members wish to speak. My final point is that if the Deputy Prime Minister is serious about protecting the NHS and achieving substantial and significant changes to the reforms, he must force his coalition partners to drop the Bill and start again.

Sarah Wollaston: I have no doubt that one of the main reasons I was elected to the House was that I promised to bring my clinical experience to bear on the health debate and to stand up for our NHS. I would therefore like to set aside party politics for a moment and give my personal take on the direction that I hope the proposed reforms will take and where we should go from here.
	At the heart of the Bill lie issues of choice, competition and clinical commissioning. My right hon. Friend the Member for Charnwood (Mr Dorrell) set out clearly the huge funding challenges that face the NHS. We have always had rationing in the NHS, but we are squeamish about discussing it. In an ideal world with unlimited resources, unrestricted choice would of course be a good thing, but it is not deliverable. Because of the limited budget, we need to focus on getting the very best value while openly and honestly involving communities in how we do that fairly. If that happens locally, one person’s local commissioning becomes another person’s postcode lottery.
	The central problem with unrestricted choice in the form of the “any willing provider” model is that it forces commissioners to act as bill payers and has the potential to undermine good commissioning. What is the point of commissioners designing high-quality, locally responsive clinical pathways that deliver good value for money for the whole community if patients have a free choice of any willing provider and commissioners have no choice but to write the cheques?

Chuka Umunna: The hon. Lady has long experience of working in the sector. One of my concerns about the “any willing provider” model is how it will potentially disadvantage teaching hospitals. [Interruption.] The Minister of State, the right hon. Member for Chelmsford (Mr Burns), might want to listen to this, because one of the hospitals involved is St Thomas’s, which serves the House, and if he fell ill here he would probably go over there. One of my concerns is about how teaching hospitals will be able to compete with other providers given the extra burdens of training and supervising those who are learning to work in the NHS. Does the hon. Lady share that concern?

Sarah Wollaston: Of course, one of the greatest burdens on many hospitals is that of the private finance initiative, and I will come to the issue of training later. I am not
	opposed to competition in the NHS, but it should not be an end in itself. It can have a role in improving some services—take, for example, the provision of mental health services and talking therapies, on which I am repeatedly told that the voluntary sector delivers better results. If I were facing a long wait for an MRI scan, for example, I would not mind if it was provided by the private sector as long as it was free to me at the point of use as part of the NHS.
	The point is that competition should be used only where there is evidence that it can deliver real benefits for patients and value for money for the whole patient community. If competition becomes an end in itself, that can actually increase costs and risk fragmentation. For that reason, I hope that as the Bill moves forward, there will be fundamental changes to the role of Monitor. The NHS cannot operate like a regulated industry, and I believe that concern about the proposed role of Monitor is the impassable barrier to co-operation from the professions, without which we will not achieve the great success that we need from these reforms.
	We must return to the original promise of the reforms, which was about clinical commissioning and a focus on outcomes rather than targets. For years, commissioning has failed because decision making in primary care trusts has not been clinically led. The NHS has been dogged by illogical care pathways, top-heavy management and a target-driven mentality, often completely divorced from any evidence base. The idea that clinicians should be put at the heart of decision making is still very sound, and it has become divisive only because of the stipulation that GPs should hold all the cards and be the sole commissioners.
	Where clinical commissioning is already successful, that is achieved through a collaborative process with multi-disciplinary input. I hope that as a result of the Government’s welcome listening exercise, the call to broaden the membership of commissioning consortia will be heeded, along with the need for a more graduated and phased introduction so that consortia are authorised only when they are ready. The same should apply to foundation trusts. They should take on functions only when it is right for that to happen.
	If commissioning consortia are to achieve the best results for their patients, they will need to focus on the integration of health and social care, as my right hon. Friend the Member for Charnwood said. I pay tribute to Torbay, which was at the forefront of moves that were widely applauded nationally and internationally, including by the King’s Fund, and that achieved real results for patients, driving down unnecessary admissions and improving outcomes. The integration of health and social care is complicated to achieve, so perhaps Monitor could have a relevant role in it—not arbitrating in disputes about competition law, but driving down costs and facilitating integration. We know that splitting tariffs, for example, could benefit community hospitals. Again, that is complex to achieve, so perhaps Monitor could also help in that regard.
	For consortia to succeed, not only do we need to focus on the make-up of their boards, but they must be geographically logical and, I am afraid, cater for geographically defined populations. Giving a free choice to register with any consortium risks encouraging consortia
	to cherry-pick their patients. One striking feature of the Bill is its sheer scope. All junior doctors will remember the fiasco of MTAS—the medical training application service. We currently have a successful model of deaneries in this country. I hope that we can retain them as the Bill goes forward, because they have a vital role to play in encouraging quality. Of course they are not perfect, and they need to look at regional variants, but we should keep our deaneries.
	Speaking of quality, at present, PCTs play a vital role in maintaining what is called the performers list, on which all GPs have to be registered in order to practise in an area. As we move forward, we need to clarify who will take over that role. That is particularly important because we have a crisis with many doctors coming here, particularly from the European Union, who do not speak adequate English, as we saw in the case of Dr Ubani. We need to ensure that the person responsible for the performers list can get rid of this nonsense, so that all doctors not only have the necessary qualifications, clinical skills and experience, but have good spoken English.
	I welcome this listening exercise, which I believe is genuine, and I hope that the Opposition will engage with it constructively. The public’s affection for the NHS is well justified. At its best, the NHS is outstanding. Where that is the case, it is not competition that has delivered those good results, but a relentless focus on what is right for patients. We need to do the same in this House.

Valerie Vaz: It is always a pleasure to follow the hon. Member for Totnes (Dr Wollaston) and to serve with her on the Select Committee on Health.
	I welcome this debate, which is the first chance that the House has had to debate the NHS after the pause—the listening, reflecting and engaging exercise—since Second Reading of the Health and Social Care Bill. Something about this debate made me think of the words of The Beatles song “Hello, Goodbye”. Madam Deputy Speaker, you can imagine the discussion in No. 10 between the Secretary of State for Health and the Prime Minister: “You say stop, I say go. You say, ‘Why?’ I say, ‘I don’t know.’” I promise it sounds better when sung. We can see now why The Daily Telegraph said this Saturday that the Secretary of State was to get first aid from the No. 10 spin doctors.
	It is right that the Government should take on board the voices in this House and outside—those of the experts, the patients, our constituents—not in reselling their proposals, but in fundamentally changing them. I wish to cover three main areas: accountability, costs and other concerns. On accountability, as a member of the Health Committee, which is so ably chaired by the right hon. Member for Charnwood (Mr Dorrell), we have heard evidence from expert after expert—from the BMA, which I promise was not whingeing, to GPs, nurses and public health clinicians—all of whom expressed concerns about the lack of detail on the ideas in the White Paper. Matters did not become much clearer even on Second Reading.
	Our latest report, “Commissioning: further issues”, published on 5 April, said that there should be no doubt that the Secretary of State has ultimate responsibility,
	but that is not clear from the Bill. We have concerns about accountability and the governance arrangements for the consortia that will be responsible for £60 billion of public money, but that issue is not clear in the Bill. There are concerns that private and voluntary providers will not be covered by the Freedom of Information Act 2000, which is not dealt with in the Bill either. Concerns remain about conflicts of interest in respect of GPs who are commissioners and providers, but that is not clear in the Bill.
	Some PCTs were working with clinicians to provide a more integrated service. A more evolutionary and cost-effective approach would be to remove the non-executive directors of the PCT boards and replace them with GPs. That would have been not a top-down reorganisation, but a progressive and less disruptive approach.
	I am staggered by the uncertainty surrounding how much this reorganisation will cost the taxpayer. The proposals in the White Paper were neither costed nor explained, and the spending is not committed, so it must come out of revenue. Professor Kieran Walshe, of Manchester Business School, put the cost at £2 billion to £3 billion, but the Government’s figure is £1.4 billion. The redundancy costs alone amount to £852 million. Sir David Nicholson said that the running-cost envelope was £5.1 billion for the running of the current service and the development of the consortia. In an written parliamentary answer to me, the Minister said that the spend and operational arrangements of pathfinder consortia are not being monitored. That smacks of fiscal incompetence and a Department that has lost control of its budget. It is so out of control that the head of Monitor wrote to foundation trusts, telling them that the NHS must find savings of 6.5% rather than 4%. That is an extra £1.1 billion on top of the savings demanded by the Department.
	Members will be interested to know that the head of Monitor compared the NHS under the Government’s proposals to privatised utilities. Does Ofgem have trouble regulating the utilities? It was ineffective in dealing with companies’ unfair pricing practices and companies that made large profits during the recent severe weather.

Lilian Greenwood: Does my hon. Friend agree that the Government’s plan to abolish the cap on income from private patients is a real concern when hospitals are starved of cash, because it could result in them putting private, fee-paying patients ahead of NHS patients?

Valerie Vaz: I absolutely agree with my hon. Friend.
	We were told by Sir David Nicolson that very little work has been done on what will happen in 2013-14. Just for the record, the UK had the second-lowest debt in the G7 in 2007-08, before the global financial crisis. Which Government are out of control with their spending?
	Finally, there are many unanswered questions. I have tried to obtain the legal advice on whether EU competition law applies to the provisions of the Bill from the Secretary of State, but apparently, it is in the public interest not to disclose that to the public. However, in a recent article in the British Medical Journal, Rupert Dunbar-Rees, a GP, and Robert McGough, a solicitor, say that
	“the technical argument reinforces the logical argument that the reforms further open up the NHS to EU competition law.”
	Who will account for the training of doctors, and indeed health care professionals? That cannot be left at a local level. In A and E, an increased percentage of patients wait more than four hours, the maternity service in Maidstone has been closed despite GP opposition—

Dawn Primarolo: Order. I am very sorry to interrupt the hon. Lady, but the clock is not correct. If she is following that, she will not know that she does not have that much time left—the clock stopped and did not start again. I would advise her to take about another minute and a half only.

Valerie Vaz: At Barts specialist regional cancer care unit, 20% of staff have been cut in two weeks.
	An Ipsos MORI poll found that 71% agree that the NHS is the best in the world and that 72% express satisfaction with the NHS, but that was published by the Department only under pressure.
	Finally, there have been 6,000 responses to the White Paper. The people of England have given their proposals, but they have not given their verdict on the Bill. They want the Prime Minister to keep his promise. If he does not do so, they will be ready to give their verdict at the next general election.

Several hon. Members: rose —

Dawn Primarolo: Order. May I apologise to the hon. Lady for the error with the timing? It was very gracious of her to ensure that she stayed within the time, which allows others to speak, but I think she will find that she got her time anyway.

John Pugh: This is déjà vu. In the last Parliament, it seemed like every other Opposition day debate was a health debate, normally called by the Secretary of State as the then Opposition spokesman. I trust that his enthusiasm for these debates is undimmed, although given that he has left us, possibly it is.
	The Opposition allege that the Bill prepares the ground for the complete privatisation and fragmentation of the NHS through the introduction of an open market, pricing and competition regulation and the general disengagement of Government. However, the often very pained response of Ministers—this was certainly true in the Bill Committee—is that they are building and improving on previous policy, linking clinical decision making to cost control and adding a dimension of accountability that has not existed hitherto. All those statements are true. I noticed that in the Bill Committee, Ministers talked all the time about “refracting mirrors”, “Opposition fantasies” and “deliberate distortions”. In turn, the Opposition talk of “hidden agendas”.
	On reflection, I have come to the conclusion that there has to be an explanation for this strange phenomenon, this persistent conflict between interpretations of the same legislation, this clear non-meeting of minds.

Grahame Morris: Will the hon. Gentleman give way?

John Pugh: I was just about to give the answer, but I will give way.

Grahame Morris: Is there not a simple solution? It is the Government’s Bill, so why did they not explicitly rule out price competition in the Bill?

John Pugh: I have a different explanation, which is that both interpretations can be sustained by a reading of the Bill. It is a kind of Jekyll-and-Hyde thing. I have a vision of the Bill being drafted during the day by a sane, pragmatic Dr Jekyll-like Minister, but during the night some rabid-eyed Mr Hyde with right-wing ideology breaks into Richmond House and changes many of the sentences. That is the only way I can explain the fact that the explanatory notes to the Bill provided in Committee explained very little.
	The House might know that I am a long-term critic of the Bill and the White Paper before it. At the annual Liberal Democrat conference in October, I and the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow) went around with a double act on the Bill—him for, me against. This is not, therefore, as the hon. Member for Easington (Grahame M. Morris) might think, a hissy fit following poor election results. Like nearly everyone in the House, I do not disagree with the Bill’s objectives: more clinical involvement, less bureaucracy and more local accountability. Like everyone else, I am concerned not about its objectives, but about its likely effects. I have met no one who takes issue with the Bill’s avowed intentions, but I have met many who dread its consequences.
	According to one reading of the Bill—the Mr Hyde version—the eventual outcome of the Bill will be that the NHS opts out of direct health provision and becomes simply a funding body; NHS hospitals, services and clinics become indistinguishable from private ones; everyone competes on business terms for a slice of whatever funds the Government have allocated for health purposes; and what health care a person gets depends on what can be purchased on their behalf in a largely unconstrained, privately run health market. That is a perfectly consistent view of how a health service can be run, but in our country any party that advocates it commits political suicide. Furthermore, of course, it is likely to accentuate health inequalities and overall costs.
	The question for us is this: what will prevent such a situation from arising out of a Bill that appoints a competition regulator along the lines of Ofgem to promote competition, that blurs many of the lines between private and public provision, and which removes the Government’s duty to provide a comprehensive health service? Hence the importance of today’s debate, which, knockabout apart, is crucial to the wider debate on the Bill. To be alarmed by the prospect I have set out is not to oppose competition in principle. The previous Government set up competition and collaboration panels to encourage a degree of challenge in the system. In fact, if hon. Members look at their record, they will see that they were knee-deep in competition initiatives. Neither is holding these concerns to be alarmed by the presence of private business in delivering NHS services. There is not a person here who has not used a private optician or a private pharmacist when they need it. There is a long tradition of involvement by the private sector in the NHS.
	Rather, to be concerned about the proposals is to be alarmed by the fear of an unconstrained, uncontrolled market in health—this is a point that has been made
	previously—partly because it can lead to fragmentation, potential conflicts of interest, profiteering and so on, but mainly because identifying competition as the main engine of improvement in health care ignores the simply enormous gains in service quality, cost reduction, efficiency and patient experience that can be gained through co-operation, collaboration and integration of services.
	The NHS is built on the principle of co-operation, in which we, the hale and hearty, make a moral compact to support the lame and the sick. To make commercial competition the main driver of improvement in the NHS, even if it is not competition on price, would be a serious mistake. It would be to subscribe to a perverse and misguided form of social Darwinism. Competition is a mechanism; it is not an end in itself. The role of competition in the NHS, as seen by the Government, is the real issue. The problem is made a lot worse by the hopeless lack of clarity over how European competition law will apply. We struggled with that issue in Committee. We did not resolve it, and I do not think that we will do so.

Owen Smith: Does the hon. Gentleman share my concern that in today’s debate, as in the long period we spent together in the Bill Committee, the Government have failed to clarify how competition law will apply? Indeed, they have sought repeatedly to imply that it will not bite any harder on the NHS. Does not that verge on disingenuousness from the Government, if not downright dissembling?

John Pugh: I think that that is a bit unkind to the Government. I have been to the Library and borrowed some very big books on EU competition law, and the main conclusion that I have drawn is that the law is not at all clear when it comes to the provision of public services. But that adds to the risks created by the legislation, and gives rise to the awful thought that the fate of our local services, about which we all care, could be decided not by the NHS, not by the Government and not by the public but by case law—European case law, at that—and in the courts.
	If we subject clinical services to the same regime to which we have subjected non-clinical services, we will not get the innovative social enterprises strengthening existing provision that people would like to see; we will get large companies financed by private equity muscling in and challenging tendering processes, backed up by legal teams and looking for every weak link or failure to comply with EU regulations. Indeed, that is already happening with non-clinical services.
	That is why there is a problem, and it is why private equity is licking its lips. We cannot additionally expect the private sector to come into this game to bid for the unprofitable, high-risk, complex work and not cherry-pick. That is not what businesses do. Good businesses pick cherries, because they need to make a profit. To suggest, as Clare Gerada of the Royal College of General Practitioners has done today, that there is not a problem of untrammelled competition in the legislation is entirely to miss the point. We are not anti-private sector, and we are not anti-competition; we want to see a level of robust pragmatism supported by those with a lifetime’s experience of running health services, and a recognition that good health care is essentially a collaborative exercise. If we cannot get that recognition and the acceptance of
	the professional bodies for what is embodied in the Bill, everything we say here and every amendment that we make will be utterly pointless.

Several hon. Members: rose —

Dawn Primarolo: Order. A large number of Members still wish to speak, and we simply will not get everyone in unless I reduce the time limit further, so that is precisely what I am going to do. The time limit for contributions to the debate from Back-Bench Members is now five minutes.

Debbie Abrahams: It is a pleasure to follow the hon. Member for Southport (John Pugh). A lot of water has passed under the bridge since the middle of March, when we last debated the NHS. The Committee tasked with scrutinising the Health and Social Care Bill, on which I served—a baptism of fire—finished its deliberations at the end of March. I believe that it was the longest running Bill Committee since 2002, so it was a marathon stint in which we debated 280 clauses and 600 amendments. During those eight weeks, the Government did not accept a single amendment. Some hon. Members made exceptional speeches, dissecting the Bill in detail and arguing against it. I remember in particular a debate about regional specialist services and how they would be commissioned in future. I am afraid, however, that that was as far as it went when it came to changing the Bill. I was therefore nonplussed when, the day after the Committee finished its proceedings, the Prime Minister and the Deputy Prime Minister expressed their concerns about the Bill and announced a pause in its enactment.
	At the same time as the Public Bill Committee was sitting, we saw growing public anxiety about what the Bill would mean to patients and their families. I was contacted by hundreds of my constituents and received a petition signed by nearly 300,000 people from across England. Perhaps that was the motivation for the Government’s change of heart, or was it just political rhetoric with the elections looming? There has certainly been no pause in NHS reorganisation in many areas, including my own, where, as I mentioned the other week, it has actually been brought forward.
	The public are beginning to see an erosion of the considerable improvements made in the NHS under Labour, and this is what is fuelling public concern. In Greater Manchester, as Peter Thornborrow, one of my constituents found out to his cost, there are much stricter criteria for cataract surgery, as there are for hip and knee replacements.

Andrew Bridgen: Recent OECD research shows that, despite the last Government’s spending splurge on the NHS, Britain still has the eighth worst record of all its members for preventable deaths—we are down there with Poland, the Czech Republic and Mexico. It also shows Britain has the seventh highest potential for efficiency savings in health care—that is, for improving patient outcomes without spending any more money. Is that not a damning indictment of the last Government’s health policy and does it not mean that reform is essential for the future of the NHS and for improving patient outcomes?

Debbie Abrahams: How will breaking up the NHS improve that? The hon. Gentleman should be concerned that some of the measures PCTs are having to take are increasing the risks of cardiovascular disease for many patients. As for international comparison of our NHS, it is known to be one of the most cost-efficient health systems in the world.
	Bariatric surgery provides another example of where the National Institute for Health and Clinical Excellence guidelines have been replaced with more stringent criteria, rationing access to care in order to balance the books. There are many other examples. According to one survey published last week, demands for bariatric surgery have risen by 17%, but approval for such surgery has fallen by 22%. These are the so-called efficiency savings, as we heard from the Secretary of State, of £20 billion nationally and 4% each year.

Guto Bebb: We hear a lot about the effect of efficiency savings on the NHS in England. Under Labour party proposals, Wales is not suffering from efficiency savings, but from cuts of £435 million in the NHS budget this year and £1 billion in the next four years.

Debbie Abrahams: Does not the hon. Gentleman think that that is why we won the election in Wales?
	The savings required are 4%, and if the Government get their way with the new economic regulator Monitor, they could go as high as 7% each year—far more than our NHS is capable of coping with.
	My constituent, Peter, was refused a cataract operation, yet his vision was so poor that he was able to see the world only through a haze; as a precision engineer, furthermore, he was not able to do his job and faced the threat of redundancy. In other cases, non-compliance with NICE guidelines—on familial hypercholesterolaemia, for example—is leaving people at extreme risk of untreated cardiovascular disease.
	Health professionals have almost without exception castigated the Bill for what it will do to the NHS in completely opening it up to the market, with competition law applying in full and allowing private health care providers to cherry-pick profitable services. A hospital medical director said last week that he did not know how his hospital could continue to provide care for unprofitable patients.
	The unprofitable services for most hospitals are elderly care, mental health, paediatrics and maternity, which are essential services for all communities. Instead of service providers and commissioners working together to provide the best quality care they can for their patients, the trend is for hospital trusts to maximise income and compete against each other. We are already seeing that lack of co-operation when PCTs look at alternatives in commissioning. Trusts are reluctant to collaborate when they see that it might reduce their income, even if it improves the quality of patient care. Similarly, the Bill gives GPs a financial interest in restricting or refusing treatment in order to make savings and to get bonus payments from the NHS commissioning board.
	Labour wants genuine savings that will enhance patient outcomes rather than produce the diminishing effect that we are currently seeing, and we believe that we can
	achieve that. We want hospital specialists and GPs to work together to deliver clinical care pathways that improve the quality of patient care and bring care closer to home. One local PCT is trying to introduce the use of drugs that are cheaper—and unlicensed—to treat age-related macular degeneration, but it is under severe pressure from the pharmaceutical industry. That is another way in which we could reduce costs.
	There is no doubt in my mind that, unamended, the Bill threatens the founding principles and values of the NHS. It removes the duty to provide a comprehensive health service, and provides an opportunity for the new NHS commissioning board and GP consortia to charge for services. It involves a costly, ideologically driven reorganisation of the NHS that has no mandate from the British people, and no support from health professionals and that will mean the end of the NHS that we know and love. As I have said before, the NHS is not just an organisation that plans and provides our health care; it reflects the values of our society on which this country set such store.
	I know that there are many members on this side of the House—

Dawn Primarolo: Order. The hon. Lady’s time is up.

Tony Baldry: When in government, the Labour party acknowledged that the NHS would have to make considerable efficiency savings over the next few years. My right hon. Friend the Member for Charnwood (Mr Dorrell), the Chairman of the Health Committee, has described that as the Nicholson challenge. The more I listen to speeches from Opposition Members, the more I am convinced that their opposition to the Bill is a cynical exercise. Given the Nicholson challenge, if at any time any hospital gets into difficulty, the Opposition will simply say, “That’s a consequence of the health reforms.”
	All of us in the House want to ensure that we get the health reforms right. I suspect that for all Members of Parliament the NHS in their own constituencies is one of the most important political and, indeed, constituency issues, but for me one of the main issues was, for much of the last Parliament—and still is—the need to retain the full range of services at Horton general hospital in Banbury. If there are difficulties in the NHS, it is hospitals such as the Horton that will experience them first. It is therefore imperative, for me, that we get the reforms right, but I have every confidence that the Secretary of State and his ministerial team will get them right.
	The Secretary of State, the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), and pretty well every other health Minister has been to Banbury to visit the Horton. As the Secretary of State made clear to GPs in Banbury not so long ago, GP commissioning enables GPs to put their confidence in their local hospitals by commissioning services for them. In my county we will be replacing an Oxfordshire-wide PCT with an Oxfordshire-wide GP-led commissioning body, with GPs in the county working collaboratively.
	In the brief time I have to speak, I want to make two points to Ministers. While I am sure it is right for us to pause and listen, we should also recall that GPs are keen to get on with this task. I have had public meetings in my constituency that have been open to every GP on my patch, and the message that I have received from them is that they want to be catalysts for change: they want to be able to shape health services in Oxfordshire.
	GPs throughout the county recently elected Dr Stephen Richards to lead the development of the Oxfordshire GP consortium. His first comment was this:
	“GP practices are the bedrock of the NHS. Now, the whole GP community, from partners and sessional doctors through to GP trainees are in a unique position to reshape health care for the population of Oxfordshire.
	The new Consortium Lead and the Locality Leads in OGPC”—
	the Oxfordshire GP consortium—
	“will have much greater influence over the improvement of patient care. These GPs will be accountable to their GP colleagues”
	and
	“to the public... I aspire to Oxfordshire leading the way in developing ‘Evidence Based Commissioning’. A new form of commissioning that offers contracts based on incentives and agreed improved patient outcomes.”

Andrew George: Will my hon. Friend give way?

Tony Baldry: No, I am not going to give way as I am conscious that many Members wish to speak, and Madam Deputy Speaker has already told me off this afternoon for taking too long.

Dawn Primarolo: Order. I was not telling the hon. Gentleman off; rather, I was reminding him of the convention.

Tony Baldry: I can recognise a chastisement when I see it!
	GPs want to get on with things, and while it is important that we should pause and have a listening exercise, we also need to give GPs the confidence so that they continue to plan for GP-led commissioning.
	The more I listen to the contributions in the debate, the clearer it becomes that each Member has their own agenda of changes that they wish to be made. Much has been made of the 98% vote against my right hon. Friend the Secretary of State by the Royal College of Nursing, but I listened to Peter Carter, chief executive and general secretary of the RCN, on “The World at One”, and I was so struck by what he said that I took down a transcript. Martha Kearney put it to him—

Dawn Primarolo: Order.

Tony Baldry: Am I out of time, Madam Deputy Speaker?

Dawn Primarolo: Yes. Thank you.

Frank Dobson: The current situation is extraordinary: the Liberal Democrats originally denied our criticisms of the Bill, but they have now suddenly jumped on board, and all I can say is that they are very welcome.
	Both Lib Dem and Tory Ministers have claimed that the NHS is a failure, and the Secretary of State said today that he had inherited Labour’s mess. Labour’s mess was to leave the national health service in the best situation it has ever been in: more successful than ever before and improving rapidly, with waiting lists and waiting times reduced to the lowest they have ever been, and with massive improvements in survival rates. From listening to Opposition Members, people would never imagine that when we came to power 5.9 million operations were being carried out in NHS hospitals, yet when the current Government came to power we—or, rather, the people working in the national health service—had increased that to 9.7 million, which is a rise of 64%. For instance, the number of cataract operations carried out each year had increased from 165,000 to 346,000.
	There have been massive improvements, and I personally do not give a toss what the OECD says. The national health service is more cost-effective than practically any other system, and it achieved that by making many different sorts of local changes—not structural changes, but by people going about their professional business trying to do things better. The Labour Government facilitated that in a body that is essentially co-operative in its organisation, ethic and culture. That is because it is based on the pooling of costs: all of us pay in, and if we get ill we get treated without having to pay. That is not going to happen any longer, because under the Bill’s provisions both the commissioning bodies and the hospitals will be able to decide to charge for some of the services that are currently free. The new chief executive at the Whittington hospital has told us all that.
	There is not just a pooling of cost and risk in terms of patients. There is a pooling of risk and cost across the national health service, so that these co-operative organisations share the costs of providing treatment and care. That will not prevail if they are forced to compete with the private sector because, as the hon. Member for Southport (John Pugh) pointed out, the first, and only, legal priority of private sector organisations is to look after the interests of their shareholders. They will therefore concentrate on creaming off the profitable work, leaving the national health service to try to provide the services that are too expensive for the private sector.
	I did not support the bits of privatisation that the previous Labour Government introduced so, unlike the Tories, I have been consistent. UnitedHealth took over three GP practices in my area not that long ago and that American-based company has just sold those three franchises to another supplier without any consultation with local people, patients or staff. It regards its function as taking part in a commercial set-up and a commercial transaction, and that is what we face if this Bill goes through.
	The problem is that the transaction costs—the bureaucratic costs—will actually rise. Before the previous Tory Government introduced the internal market, the money spent on NHS bureaucracy was just 4%, but that has increased to 12%. I am willing to bet any Member on the Government Benches that the level will go well above 12%, because once legal contracts are required, once the lawyers, accountants and God knows who else gets involved and has to be paid, and once we end up with court actions, the transaction costs will rise. That is why these proposals are a disaster.

Andrew George: It is a pleasure to follow the right hon. Member for Holborn and St Pancras (Frank Dobson) and I was glad that his speech contained an element of recognition of the excellent contribution made by my hon. Friend the Member for Southport (John Pugh), who set out far more articulately than I could many of the concerns about the Bill that underpin this evening’s debate. These concerns have been raised by Liberal Democrat Members and I know for a fact that a number of Conservative colleagues feel the same way about aspects of the reform, although that has not been articulated this evening.
	I wish to get one piece of rough and tumble out of the way before I commence with the substantive comments I wish to make in the short time available to me. I will not be supporting Labour’s motion this evening because to do so would be to endorse Labour’s history of having introduced the following: independent treatment centres, which wasted hundreds of millions of pounds of taxpayers’ money; alternative providers of medical services enforced through primary care trusts; and many other top-down reorganisations, which Labour Members now pretend they are against. It would also mean endorsing their approach to the whole concept of top-down reorganisations, the billions that Labour wasted on NHS IT systems and Labour’s failure to address the unfair funding formula, which set back my part of the country significantly and left it in significant debt, from which it is still trying to escape.
	I set out my position in the Second Reading debate on the Health and Social Care Bill, on 31 January, when I refused to support the Government because of the criticisms and concerns that I raised then. I do not need to repeat them now, but I also made it clear then, as I do now, that I would vote against the Government on Third Reading if the Bill were to look in any way like the measure that we saw come out of the Committee and that will come through to the Report stage. I therefore look forward to the outcome of the listening exercise, and hope that it is a genuine listening exercise and that substantial changes will be made to the Bill. The changes that I wish to see are so substantial that they would take the guts out of the Bill.
	To the concept of commissioning proposed in the Bill and the idea of handing all that power to one narrow group of clinicians—GPs—there is, despite what the hon. Member for Banbury (Tony Baldry) said about GPs in his area, at best a resigned reluctance and at worst outright hostility about what GPs are being asked to do. I do not go along with the hon. Gentleman’s view that they are keen to get on with it. They are responsible people and responsible professionals; they recognise when they are being asked to do something and they will get on with it, but I must say that they will not do so with any enthusiasm.
	Secondly, the substantial elephant in the room is not the risk of privatisation of the NHS, as the hon. Member for Easington (Grahame M. Morris), who is no longer in his place, described it, but the marketisation of the NHS. My hon. Friend the Member for Southport (John Pugh) put it well: the cherries will be picked by the private sector. Any decisions on commissioning could easily be unscrambled by a process whereby decisions that were intended to try to integrate services could be challenged because they were structured uncompetitively. Those are two fundamental failings in the Bill.
	This comes to the heart of what coalitions are about. No one gets their own way, as Labour knows from being in coalition in other places, and it is silly to be childish about that. In a coalition, the parties work together when they agree and seek a compromise where they fail to agree. I would argue that when they cannot come to any kind of agreement or compromise, they should allow Parliament to decide. What I do not like about what is happening is the fact that the Secretary of State is largely implementing this—

Dawn Primarolo: Order.

Owen Smith: I am delighted to follow the hon. Member for St Ives (Andrew George) and to hear him say that, were this a Third Reading debate and the Bill had remained as it is, he would vote against it. He should not hold his breath, because we have not heard any indication from those on the Treasury Bench that they propose to listen to the reasoned and substantive opposition that we heard in the Public Bill Committee, of which I was a member and where the Government rejected all 250 to 300 suggested amendments, or to that in the rest of the country, where doctors and all the medical professions are united in opposing the Bill.
	Earlier, those of us on the Opposition Benches were admonished for the sound and fury coming from us. Mr Speaker was right to admonish us for shouting, but that sound and fury is not born of cynicism; it comes from three things. The first is our outrage at how the history of what the Labour Government did in office is being rewritten and at the suggestion that this Bill represents an evolution of what we did with the NHS. It is not an evolution, but a revolution.
	The second is the shameless way in which the Government are misrepresenting that which sits at the heart of the Bill. They present it as trying to bring about patient focus and GP-led improvements to the NHS, but in truth it is about competition and the Government’s belief that competition in health care, like in telecoms or the energy market, is the best way to drive improvements in the efficient allocation of resources, allowing consumer-driven demand to drive efficiency. We fundamentally contest that. We do not think that it is true in many aspects of life, but it is certainly not true in the NHS, a body built on collectivism, co-operation and integration. Those fundamental ethics—the ethos of the NHS—will be undermined by the Bill.
	Thirdly, the Bill is a completely unnecessary intervention. We did not need a top-down reorganisation of the NHS, because we got record patient satisfaction and increased productivity in all the ways that matter, as described earlier by my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). Crucially, we have a far more efficient and better-resourced system than previously. That prompts the question of why the Government are pursuing this change. They are doing so because they fundamentally believe that the way to drive the NHS forward is an unfettered market and greater deregulation.
	That brings me to my substantive point. I want to rebut the notion which we have heard repeatedly from the Government that competition will not bite harder
	on the NHS as a result of the changes. The Government have told us repeatedly that nothing in the Bill says that competition will impact on the NHS to any great extent. As we all know, however, in 100 of the 300 clauses Monitor is established as an Office of Fair Trading-style competition overlord for the NHS, because as soon as the NHS is opened up to multiple entrants in the market and there are multiple providers of health care services in this country, we will no longer be able to argue that it is a state service that ought to be protected and therefore should not be subject to the vagaries of the market and EU competition law. As soon as we allow multiple health providers into the market, we will have to apply EU competition law, and European case law and arguments between lawyers will inevitably lead to the progressive fragmentation of the NHS.
	There is one other point with which I want to take issue. Privatisation is a pretty difficult word to bandy about in politics, but I do not shy away from using it in this debate. We are going to see a progressive and creeping privatisation of the NHS. To argue about marketisation and privatisation is to argue about semantics. We will increasingly see many more aspects of the NHS either in the hands of or being delivered through the private sector. Earlier, the Secretary of State asked us to point out where in the Bill it showed that there would be an increased number of private providers in the NHS. My challenge to the Minister of State, Department of Health, the right hon. Member for Chelmsford (Mr Burns), who is now back in his place, is to point out to me where in the Bill it says that we will not see more private providers entering the marketplace. The Bill provides for that to happen and what will arise from that is the break-up, fragmentation and, eventually, privatisation of the NHS. Those on the Government Front Bench know that—

Dawn Primarolo: Order.

Daniel Poulter: I agreed with very little of what the hon. Member for Pontypridd (Owen Smith) said when we were on the Public Bill Committee together, and I am afraid that I will not change my view after hearing what he has said today. He touched, however, on the important issue of health economics. In a thoughtful speech, the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) made some good points about health economics. Much as I would rather talk just about patient care, given my medical background, health economics are at the centre of the discussion about how we will reform and improve the NHS.
	The comprehensive spending review announced that the NHS would see its funding rise by 0.4% in real terms over the next four years. Despite the current economic climate, the Government have stood by their commitment to increasing NHS funding over this Parliament—we are very proud of that—but, even so, it is the smallest increase in NHS funding for decades. Ever-increasing patient demand for health care coupled with Britain’s demographic time bomb means that over the next few years the NHS will have to achieve value for money for its patients on an unprecedented scale.
	Our NHS needs to make efficiency savings just to stand still and to continue to deliver high-quality patient care. My right hon. Friend the Member for Charnwood
	(Mr Dorrell) hit the nail right on the head when he said that we need to think about not just the worried well but the 80% to 85% of patients who have serious medical co-morbidities or present as emergencies with acute medical problems in accident and emergency. That desire lies at the heart of the Government’s proposed reforms.
	People are living longer, and as they do the number of people living with multiple medical co-morbidities also increases. The majority of people require their health care in the later stages of their lives and if we are to have an NHS that is truly responsive to the demographics of this country, we need to ensure better integration of health and social care. We must stop the silo working that often exists between local authorities and the NHS and ensure that we have a more locally responsive NHS. At the heart of the Bill is a desire to see better integration of adult social care and NHS care, which can only be a good thing in view of this country’s demographics and of the health economics of looking after people in the later years of their lives.

Debbie Abrahams: Does the hon. Gentleman share the concern that many councils that will be responsible for the delivery of public health are not ring-fencing the money and are using it to offset some of the cuts that they face?

Daniel Poulter: I can only say that my Conservative-run, Suffolk council is doing exactly the opposite of what the hon. Lady describes. The Government have committed to putting almost £2 billion into adult social care, looking at the demographic time bomb and looking at better integrating health care with adult social care. I would be very concerned to see councils doing what she describes, because that is not what they are given that money for. If she has had a problem with that at her local authority, she needs to take it up with that authority.
	The key to unlocking potential in the health sector lies in cutting the red tape and pointless form-filling that wastes the time of so many front-line staff. Of course, our NHS must have a level of regulation that ensures that products and services are thoroughly tested and that ensures patient safety. However, the over-excessive regulation introduced by the previous Government has been damaging not only to patient care but to staff morale. It has also diverted vital resources away from the front line and away from patients, who are, after all, what health care should be all about. This Government are rightly looking to take simple, obvious and positive steps in improving the overall efficiency of the NHS by scrapping the health quangos that waste £2 billion a year—money that could be much better spent on front-line patient care.
	Another issue that I want to highlight in the time left to me is another area of wasteful spending in our NHS—management. Under the previous Government, the number of managers and unproductive non-medical staff increased in the past decade, with the number of managers and senior managers in the NHS almost doubling to 42,000. In many hospitals, more new managers than new nurses were recruited in that time. That cannot be right—it is bad for patients and money is being misspent. As I witnessed at first hand, NHS managers were rewarded at a better rate than front-line staff—at around 7%, compared with 1.8% pay rises for front-line medical staff. That is not a good thing.
	The Opposition are very concerned about staff morale, but let me tell them why staff morale is so low: it is because the contributions of front-line staff were badly undervalued by the previous Government while the contribution of managers were over-valued. I believe that what we and the Government need to do is make sure that more money goes into front-line patient care and front-line staff rather than being wasted on management and bureaucracy.

Grahame Morris: rose —

Daniel Poulter: If the hon. Gentleman will forgive me I will not give way because time forbids it.
	In conclusion, the NHS needs to be reformed and needs to improve the care it delivers to patients. We can no longer afford to sustain the amount of wasteful spending on management and bureaucracy that occurs in the NHS. We need a less bureaucratic NHS—a clinically led NHS that can once again put its patients first. The NHS has become obsessed with management and process but if we want to reform it, then it must be the patient who counts.

Clive Efford: I must confess to being somewhat confused about where we have got to with the Bill. I have been here for 14 years and I cannot recall a Bill being halted after it had been through Committee so that we could go back and consult the public. I will be corrected by Members who have been here longer than me, but I cannot remember anything like this extraordinary situation.
	Yesterday, I listened to the Deputy Prime Minister on the “Andrew Marr Show”. He said:
	“Let me stress this, it’s not a gimmick, it’s not a PR exercise. We will make changes, we’ll make significant and substantive changes to the legislation”.
	We have not heard any of that tonight. No one has got up and said, “We are listening,” or, “We are pausing,” or “We are reflecting and we are going to see substantial changes to this Bill.” The Secretary of State is in his place: I would like him to intervene on me and tell me that in relation to GP commissioning, the full £80 billion will be transferred to GPs, as he has frequently stated it would; that they will be in charge of commissioning and that we will not see that altered in any significant way as a result of the interventions of the Prime Minister or the Deputy Prime Minister. Members of the Government are trying to say that they are listening and that they are not responsible for all this, but I have here the White Paper that was published back in January, the foreword of which was signed by the Prime Minister, the Deputy Prime Minister and the Secretary of State for Health. They all signed up to it, but all of a sudden we are back to pausing, reflecting and listening.
	What or who are we listening to? We have heard from the Secretary of State tonight that there are no cuts in the NHS, but let me tell hon. Members the story of Mrs Bell, a constituent of mine who was referred by her GP to a consultant last spring about cataract operations. She received the first operation within 18 weeks, and when she went back for a second consultation about the other eye she was referred for another operation. After 18 weeks, she rang the local health care trust to say that
	she had been waiting for her cataract operation for 18 weeks, but she was told that that was no longer a deliverable target. She ended up waiting more than 26 weeks for that cataract operation, so no one can tell my constituents or anyone else that we are not seeing cuts to the NHS and longer waiting times for patients.
	What is fundamentally wrong with the Bill is that it places the market at the head of commissioning and planning services. The coalition document said that the coalition was going to introduce some element of democracy into primary care trusts, but PCTs got demolished as part of the proposals. My local PCT has been absolutely decimated, because although the Bill has not gone through Parliament yet, people are acting on it: they are voting with their feet and they have all gone. Currently, my area has no one who is responsible for the oversight and planning of our local health care services. Moreover, no one who will ultimately be accountable to local people is responsible for planning local services. All of that has been frittered away; it has disappeared. What we need is some form of democratisation of the commissioning process so that local people can know quite clearly who is accountable and who is not.
	Tonight’s vote presents the Liberal Democrats—after we have paused and listened and reflected and after all they have said over the weekend about changes to the legislation—with an opportunity to send a message to the Government. This morning, the hon. Member for North Norfolk (Norman Lamb), the Parliamentary Private Secretary to the Deputy Prime Minister, said on the “Today” programme that there will be significant changes to the Bill. If the Liberal Democrats want to send a message to the Government, they should join the Opposition in the Lobby tonight and send the message that the Bill has to be changed. But I will tell them what will happen when it comes to Third Reading. The Whips will get to them, they will be as spineless as ever and they will go through the Lobby defending the Bill’s Third Reading—

Dawn Primarolo: Order.

Jeremy Lefroy: I would like to take this opportunity briefly to raise three matters and I hope that my right hon. Friends on the Front Bench will, in the spirit of the listening exercise, take note of them. I know from previous experience that these issues concern them. They arise in relation to the public inquiry that is going on at the Mid Staffordshire NHS Foundation Trust.
	First, the motion refers to an NHS that refuses to tolerate unsafe care and that achieves quality and outcomes that are among the best. I do not think that any right hon. or hon. Member would disagree with either of those aims. One thing that has come out of the Mid Staffordshire inquiry is the whole problem of unsafe care, particularly the quality of care that elderly patients receive. Mid Staffordshire is by no means the only place for which that has been a problem. It has been highlighted in a recent report as being an issue for other parts of the country as well. For me, the key question is how patient care and safety can be upheld to the highest possible standards across the NHS. Occasionally people have cited the example of civil aviation in this country. Both
	the Civil Aviation Authority, which has a first-class safety record, and the NHS serve the public. The CAA emphasises continuous improvement and risk-based monitoring. I urge my right hon. Friends to look at the example and practices of the CAA and consider how those might be incorporated in the work of the NHS.
	The Health and Social Care Bill contains helpful provisions on patient safety. GP commissioning will bring commissioning closer to patients. It will ensure that if there are problems, they will be heard about more quickly. The health and wellbeing boards will ensure greater local accountability and, again, problems should come to the attention of the authorities more quickly, which did not happen in my own trust. Healthwatch will be established and there will be more foundation trusts.
	However, there is a risk of a fragmented approach to patient safety. We have the Care Quality Commission, but as hon. Members who served with me on the Public Bill Committee know, there are concerns about the additional work load that will be placed on the commission. Will it be able to cope with the volume of work? Will it be able to ensure that patient safety and quality of care are upheld across the NHS? I should like to hear the Minister of State’s comments on that. It has been suggested that the critical question of patient safety should be brought to the top of the NHS, perhaps with a directorate within the Department of Health reporting directly to the Secretary of State on patient safety. I should also be interested in his comments on that.
	The second point that I wish to make is about foundation trusts, which were key under the previous Government and will continue to be so, but I am concerned about the level of training available to governors and directors. I should like to hear my right hon. Friend’s comments on that. I refer particularly to foundation trusts that are responsible for district general hospitals, which many hon. Members have in their constituency, as do I. Those are the trusts that will probably come under most pressure in the current constrained financial circumstances, and that would have been the case under any Government.
	My third point relates to the length of contracts that are awarded. Whatever the position is with competition under the Bill on Report, it is clear that contracts, whether with NHS or outside providers, will be of the utmost significance. I am concerned that contracts are sometimes awarded for only a short period. Hence, a considerable amount of time is taken up with tendering and retendering. I ask for some comments on that.
	In conclusion, the Francis inquiry, which we expect to report later this year, will be one of the most significant reports on the national health service in the past 20 or 30 years. I urge the Government to take good note of its conclusions and implement them as far as possible.

Alex Cunningham: At a time when the Health Secretary is being criticised from all sides, it is vital that the message gets through and the listening exercise works, but from what we have heard today there is grave doubt about whether there will be any real change.
	The shadow Secretary of State told us about the warning from the Royal College of General Practitioners that the NHS could unravel if the Health and Social Care Bill goes ahead in its current form. The British
	Medical Association says that the plans are too extreme and too rushed, and will negatively impact on patient care. Nurses voted overwhelmingly for a vote of no confidence in the Health Secretary, and even the Tory-led Health Committee criticised the plans, saying that they were unlikely to improve patient care.
	I attended a Save the NHS rally in my constituency on 30 April and spoke to local nurses, doctors and patients to hear their views. One of the GPs who was there to speak on behalf of the BMA stressed how worried they are that increased competition will lead to the fragmentation mentioned by so many other hon. Members. She also made it clear that although the Government boast that 90% of GPs have signed up to participate in a commissioning role, vast numbers of doctors have done so only because they feel they have no option. They know that it is a bad Bill, but feel the Government are imposing a way of working on them and they have no option but to co-operate.
	Four weeks earlier I joined health service workers at another public event to demonstrate opposition to the Bill. Even policemen and women passing in their vans and cars were tooting in support of the demonstration, but we know that even the police have learned that the Government have no care for public services, whether health or policing. I also spoke to local nurses who feel that they are being sidelined by the Bill and want more involvement in decisions about the future of the NHS. I, for one, support them and wear my nurses day badge with pride, albeit a few days early.
	Nurses certainly do not want a situation where GPs effectively control everything. Why, they ask, should GPs have such universal power? What about other clinicians? What about nurses? Are they not professionals with a tremendous knowledge of what our people need from their health care? I also question why local authorities and councillors who have extensive knowledge of the health needs of their communities are not to be involved in commissioning. Good local authorities work very closely with existing PCTs. Why are they being excluded?
	On Teesside we have had nothing but bad news for the NHS since the coalition was formed. One of the first rounds of spending cuts saw plans for our much needed new hospital scrapped in June last year. I know that the North Tees and Hartlepool NHS Foundation Trust took the Government at their word when they said the trust had powers to raise the funding itself and it prepared a new business plan on that basis. To make it move from new business plan to new hospital, we need to remove the uncertainty in the NHS, particularly about privatisation and competition, and we need the Government to provide a loan guarantee to help keep borrowing costs down. Without that, some of our communities with the greatest health needs will have to make do at a time when budgets are under pressure.
	More recently, people in Billingham in my constituency were told that their new £35 million community health centre would not be going ahead as the Government would not allow the public finance initiative credits for it. Under Labour we made good progress in reducing health inequalities. The new hospital and health centres were part of the strategy to build on that progress, but again the Government have shown their ignorance of the health needs of people in our less affluent communities. Jobs, too, are going—80 jobs from NHS Stockton over the next three years, with 42 jobs set to go at the North East ambulance service, and that is only the start.
	Unison, of which I am proud to be a member, has highlighted the fact that there will be more than 20,000 redundancies across the health service as a result of the reorganisation. This represents a personal tragedy for those affected and a colossal waste of talent and resources at a time when the NHS can ill afford it. Redundancy payments alone may be £l billion. To top it all, we know that waiting times are on the increase. According to the quarterly monitoring report from the King’s Fund, waiting times have hit a three-year high. What message does the Health Secretary have for the people in my area and patients waiting for operations, who know that they will have to wait much longer not only to escape continual pain, but to see their quality of life improved?
	My message today is simple. The Government must take on board the criticisms that have been made and come back to the House with significant changes. As a priority, we must keep the NHS protected against the full force of competition law, drop plans for a free market NHS and give others their proper role in commissioning services.

Emily Thornberry: This has been an interesting and important debate at an important time for our health service.

Tony Baldry: Where are they?

Emily Thornberry: I am being heckled already. I do not intend to make a habit of this—the hon. Member for Banbury (Tony Baldry) can heckle as much as he likes—but I will answer on this occasion. There is another draw this afternoon. My right hon. Friend the Member for Doncaster North (Edward Miliband) is speaking, but I understand that my hon. Friends will be coming in a moment.
	We have heard a number of interesting and important speeches from Members who have shown great expertise and have been serving the community and the public through their work on Select Committees, including the Health Committee. We heard from my hon. Friends the Members for Easington (Grahame M. Morris), for Walsall South (Valerie Vaz), for Oldham East and Saddleworth (Debbie Abrahams) and for Pontypridd (Owen Smith), and from the hon. Members for Central Suffolk and North Ipswich (Dr Poulter) and for Stafford (Jeremy Lefroy). Listening to their contributions, we have had a taste of the quality of debate that took place in the Health and Social Care Public Bill Committee. It is a shame that the Government did not give an inch as a result of those debates.
	We have heard from the Liberal Democrat representatives, including the hon. Member for Southport (John Pugh), who talked about the Jekyll and Hyde drafting of the Bill, and the hon. Member for St Ives (Andrew George), who said that he is likely to vote against it on Third Reading. We heard a characteristically passionate, robust and articulate speech from my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson). My hon. Friend the Member for Eltham (Clive Efford) asked a very simple question that I will repeat in the hope of getting an answer: what changes will be made as a result of the pause?
	I hope that the Secretary of State was listening to my hon. Friend the Member for Stockton North (Alex Cunningham) because he brought a dose of reality to
	the debate by explaining the effect the reorganisation will have on his poor constituency and the redundancies it is suffering.

Andrew Bridgen: Will the hon. Lady not concede, perhaps even reluctantly, that the real reason her party is acting as a roadblock to essential NHS reform is that it pays far more attention to its union backers and paymasters than to NHS patients and taxpayers?

Emily Thornberry: The great strength of being in opposition, in many ways, is the opportunity it gives us to listen to interested groups of every type, including representatives of the work force, experts and the public, and to hear their concerns about the Bill. Those concerns translated into more than 300 amendments that we tabled in Committee and more than 100 votes. As I have said, the Government considered it wise not to give an inch. However, on the day after the Committee finished its considerations, the Government decided that there ought to be a pause so that they could think again. The very fact that they decided to think again tends to encourage us to think that we might have been right in the first place. What a shame it was that they did not listen to us earlier.
	For the Health Secretary, it must seem a lifetime since the Prime Minister said about him:
	“He is probably the Health Secretary in the last 20 years who has the greatest understanding and greatest passion for the NHS.”
	His Deputy Prime Minister stated in the foreword to the NHS White Paper that the reforms were
	“rooted in the coalition’s core beliefs”.
	Patient groups, professional bodies and health experts gave the underlying principles of the White Paper a cautious welcome, but I ought to explain to the Secretary of State that there is a difference between giving a cautious welcome to the underlying principles of a White Paper or Bill and reading the Bill and realising that it will not deliver on those underlying core principles. That is why there has been an increasing chorus of opposition. Our difficulty is that, although there were more than 6,000 responses to the White Paper, those concerns were largely ignored. When the Bill was published, those concerns increased to alarm and the criticism became less diplomatic, less polite and more forthright, and yet the Secretary of State continues not to listen. More people began to join the Opposition’s side of the argument. Although at the beginning the Secretary of State might have felt encouraged that he had many people in his “liberate the NHS” team, as more people realised just what the Bill was about, more and more of them decided that they had been on the wrong side of the argument and that the Bill was wrong and so crossed the room.
	I pray in aid the comments made by the hon. Member for Totnes (Dr Wollaston), who talked about throwing a hand grenade into the NHS, and those of the Royal College of Nursing, which passed a vote of no confidence in the Secretary of State, with 98% of the vote. Its general secretary said that the Bill
	“could well turn out to be the biggest disaster in the history of our public services”.
	The British Medical Association called for
	“a halt to the proposed top-down reorganisation of the NHS”.
	When I listened recently to the hon. Member for North Norfolk (Norman Lamb), I was reminded of Luke 15.7 —there shall be more joy in heaven over one sinner who repenteth than over 99 just persons who do not need to repent. The number of people who are moving over to our side of the argument are becoming a flock. They say they realise that the Bill is not what they had first thought it was, that it needs to be fundamentally changed, and that if it is not fundamentally changed it needs to be scrapped.
	Lord Owen has said:
	“The coalition unexpectedly and inexplicably forged ahead with legislation for NHS reforms of staggering ineptitude.”
	Lord Tebbit, who I believe is the Secretary of State’s former boss, has said:
	“What worries me about the reforms, however, is the difficulty of organising fair competition between the state-owned hospitals and those in the private sector.”
	I could go on. Michael Portillo has said of the Tories:
	“They didn’t believe they could win an election if they told you what they were going to do because people are so wedded to the National Health Service.”
	The whole of the Liberal Democrats have also crossed the room. Evan Harris has talked about the Bill being “disastrous”. Although I heard the right hon. Member for Charnwood (Mr Dorrell) say encouragingly that the Bill would give
	“a holistic basis—a structure for the health service, going forward”,
	the Health Committee’s report has not been so enthusiastic, if indeed what he said today could be characterised as enthusiastic. Lady Williams has said that the Bill is “completely misconceived”, and the right hon. Member for Bermondsey and Old Southwark (Simon Hughes) has said that it needs “fundamental change”.
	The Health Secretary must be feeling increasingly lonely. Perhaps the most deadly time was when the Chancellor of the Exchequer stated:
	“I want changes too, and so does David Cameron”.
	I appreciate that the Health Secretary has the Minister of State, the right hon. Member for Chelmsford (Mr Burns) and the Under-Secretary of State, the hon. Member for Guildford (Anne Milton) on his side, along with the hon. Member for Banbury (Tony Baldry). I respectfully suggest to the Health Secretary that he holds very tightly to the hand of the Minister of State, the hon. Member for Sutton and Cheam (Paul Burstow). It must seem a very long time ago that the Prime Minister said:
	“I have been involved in designing these changes way back into opposition with Andrew Lansley. I take absolute responsibility with him for all the changes we are making.”
	We will see just how long it is that the Prime Minister stands shoulder to shoulder with his Secretary of State.
	There has been great excitement in SW1 bubble land on what effects the NHS reforms will have on the coalition and what the Lib Dems will do next, but the fundamental point is that it really does not matter what happens in SW1; what matters is what happens to our national health service. The Bill is a threat to our national health service. Leaving aside the political shenanigans and the saving of the Deputy Prime Minister or the Liberal Democrats’ soul, what is important is what happens to our national health service. We should be looking at the fundamental principles in relation to that. Everything else is just words, words, words. We are told that we must not rush GPs into consortia, but the
	majority of them have already been rushed into consortia and their PCTs are being abolished. If that is the extent of the fundamental reforms that the Liberal Democrats want, that would be very disappointing.
	We in the Opposition have five tests: delete part 3 of the Bill; keep waiting time guarantees; ensure that consortia are not too small, involve wider expertise and require openness and accountability; ban GP bonuses, stop conflicts of interest and do not allow commissioning jobs to be done by the private sector; and keep a cap on the number of private beds. Let us do that, which would be a fundamental change to the Bill. Most importantly, let us delete part 3.
	Instead of wasting time, energy and money on unnecessary top-down reorganisation, the Conservative party should have been building on Labour’s achievements. When we handed over the NHS to the Conservatives, we did so in trust. They should have built on our achievements. I am not saying that the NHS was perfect, but it was much better than it was when it was handed to us. These reckless, costly and ideologically driven reforms are not doing well for the health service. As the hon. Member for Totnes has said, while competition has a role, it is not an end in itself. If we allow competition to run rife within the NHS, it will fundamentally undermine its essence, which is that it is built on a culture of collaboration and co-operation. It is an expression of our fundamental commitment to equality.

Simon Burns: At the instigation of the Opposition, we have spent the past three hours debating the future of the national health service, and yet in not one single speech from their Members did we hear any mention of what they would do for the future of the NHS. We heard from the right hon. Member for Holborn and St Pancras (Frank Dobson), who is always a joy to listen to. He objected to the Blair/Brown health service reforms and to our proposals to improve the NHS, apparently without fully understanding them. We heard speeches from the hon. Members for Pontypridd (Owen Smith) and for Easington (Grahame M. Morris) that were simply a continuation of what we had to listen to for eight long weeks in the Bill Committee.
	We had a sensible and reasonable speech by my right hon. Friend the Member for Charnwood (Mr Dorrell). My hon. Friend the Member for Totnes (Dr Wollaston) made an interesting speech and was right—absolutely right—to encourage the greater integration and seamless provision of social care and health care, because that is so important.
	We had an excellent speech from my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), which was based on his experiences of having worked in the national health service, and we had a good speech by my hon. Friend the Member for Stafford (Jeremy Lefroy), who raised a number of questions. Time does not permit me to answer them all, but I remind him that, because of my right hon. Friend the Secretary of State, the Care Quality Commission started an unannounced investigation of nursing in hospitals to look specifically at dignity, respect and safety.
	During this debate there have been times when the facts seem to have been obscured, so it is time that we had a reality check: our population is ageing—in 20 years’
	time 2.5 million people will be over the age of 85; the cost of new medicines has almost doubled in the past 10 years, from £6.7 billion to £11.9 billion, rising last year alone by £600 million; and new surgical procedures are breathtakingly effective but expensive.
	Those are the pressures facing the NHS at a time of economic turmoil inflicted on this country by the previous Labour Government. As a result, there are real challenges that the NHS must meet, so it does no one any good to scream “privatisation” as soon as we start exploring the best ways to safeguard the health of our children and of our children’s children. It is scaremongering of the lowest order, because this Government will never privatise the NHS. We have been, and we always will be, committed to an NHS free at the point of use for all eligible to use it.
	In fact, when the Labour party was in government, it introduced private companies into the NHS on a scale that would have produced howls of outrage if we had done the same, but it was not privatisation then and it is not privatisation now. The previous Labour Government gave £4.7 billion to private companies in 2009-10 alone, and, unbelievably, to add insult to injury, £250 million of that money was given to private providers as payment for operations that never even happened.
	We want to see a much fairer relationship, one that does not undermine the NHS but means increased choice for patients and better outcomes. That means saving thousands of lives every single year from conditions such as heart disease, respiratory disease and cancer. It means people with long-term conditions having their quality of life revolutionised with the seamless provision of care; the care that people receive being as good it possibly can be, based not on percentages or pie charts but on people’s real experiences; and the relationship between patients and doctors being humanised rather than seen as a means to an end—a relationship of equals based on trust, transparency and the best available treatment from the best available provider.
	Every sensible-thinking person in the House knows that patient care can be improved if the NHS becomes more efficient. Efficient treatment is faster, cheaper and more effective. The previous Government knew that as well. We are carrying on their plans for £20 billion of efficiencies, plans that the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) brought in, whereby every penny saved will be reinvested in patient care.
	To those who say that the plans are happening too fast, let me remind them that this coalition Government are giving the NHS an extra year to find those efficiencies, over and above what the Opposition would have allowed. On top of that, we are protecting front-line spending and, in fact, increasing the NHS budget overall in real terms.
	We also want to see the quality of our clinical care improve so that a patient’s care will be among the best in the world, whatever they are being treated for. But these are not just pretty words and noble intentions; we are making real changes and patients can already see a real difference.
	We are removing layers of unnecessary management so that clinicians have the freedom to look after in-patients rather than inboxes, and there are examples of improvements in care throughout the country. To look
	at just one, Oxford’s John Radcliffe hospital has invested in an electronic blood transfusion system that cuts the time taken by staff to deliver blood and reduces transfusion errors to improve services for patients. That saves the NHS £1 million every year to reinvest in patient care, because it is more efficient. That is the reality of efficiency, and it goes hand-in-hand with innovative, forward-thinking care.
	Underpinning all our plans is the philosophy that a more integrated NHS is a better NHS—ending stop-start care and making sure that, from the point of diagnosis, every patient has seamless care that spans health care, social care, mental health care and, of course, a reliable support network afterwards so that patients can just concentrate on getting better.
	We want GPs and other health care professionals, social care providers and local councils to come together to provide seamless services, whereby, for the patient, the lines drawn between those organisations fade to nothing. Giving autonomy to clinicians, in the form of consortia, will allow that to happen, and I hope that that reassures my hon. Friend the Member for Totnes.
	Let us ask Dr Howard Stoate, who some Members might remember was Labour MP for Dartford until last May. [ Interruption. ] I know that the hon. Member for Islington South and Finsbury (Emily Thornberry) does not like this, but she will have to listen to it once again, because he is leading pathfinder consortia in Bexley. GPs such as Dr Stoate take a broader, more responsible view of care, working with others throughout the country and across primary, community and secondary care to manage, treat and refer their patients.
	They are all in an ideal position to design services in collaboration with all the different strands of the NHS and, of course, with those beyond the NHS as well. Patients, who will have their own personal care budgets to spend how they like, will be involved every step of the way.
	As I have said before, everyone knows that the NHS has to change. The noble Lord Warner, a Labour Health Minister for more than three years under the previous Government understands that point. [ Interruption. ] I am disappointed that the hon. Member for Leicester West (Liz Kendall) laughs, because at the time she thought that he was a valued Minister in the Department of Health. That point about change is in his book—a thoroughly good book, by the way, which I suggest she reads if she has not already done so. He says that reform is essential, because failure cannot be allowed to carry on taking taxpayers’ money and providing a sub-standard service to the public.
	Reforming an organisation the size of the NHS is a big challenge, but it is also a big opportunity. What we propose is not simply to tread water or to be satisfied with the NHS just scraping by; we want to see it improve for the benefit of patients in every way.
	There is no reason why we have to put up with care that is anything less than world-class, and our plans revolve around that happening: cutting down inefficiency; empowering clinicians; giving them—

Alan Campbell: claimed to move the closure (Standing Order No.  36 ).

Question put forthwith, That the Question be now put.
	Question agreed  to .
	Main Question accordingly put.
	The House divided:
	Ayes 231, Noes 284.

Question accordingly negatived.

Welfare Reform Bill (Instruction)

Maria Miller: I beg to move,
	That it be an instruction to the Welfare Reform Bill Committee that it has power to make provision in the Bill to establish the Social Mobility and Child Poverty Commission.
	This debate is focused on the motion and I do not intend to go through the purpose and effect of the proposed new clause in detail. Members will have the opportunity to debate the measure in full in the remaining stages of the Welfare Reform Bill, including in Committee. However, it may help hon. Members if I set out the Government’s reasons for this change.
	We need to be sure that we have the right structures in place to hold the Government to account on child poverty. The previous Government attempted to do that by enshrining in law a child poverty commission. The commission was intended to provide independent scrutiny and to ensure that progress would continue to be made by Government. We supported and still support the concept of an arm’s length body to provide such an external challenge to Government. However, having considered carefully how best to establish the commission to ensure that it can fulfil that purpose, we do not believe that the child poverty commission, as currently defined in legislation, has the necessary remit or power to perform that function effectively.
	Why do we want to change the commission? There are three reasons, which I will outline for the House. First, the commission cannot assess or comment on the progress made by Government on child poverty, meaning that it has no power to hold the Government to account. Secondly, we believe that the commission’s advisory role undermines accountability and provides Ministers with a means to delegate decision making to an arm’s length body. For a Government to consult on an important policy matter is absolutely proper, but responsibility should ultimately rest with Ministers. Finally, the scope of the commission is simply too narrow and does not cover issues that are crucially related to child poverty, such as life chances and social mobility. As I have said, this debate is not the place to go into the detail of the proposed new clause. It is intended to address the concerns that I have raised and to ensure that the commission has the functions and power that it needs to drive progress effectively and hold the Government to account.
	It is appropriate to use the Welfare Reform Bill to make this change because helping people who are dependent on welfare to help themselves is one of its key aims. The reforms are designed to do that in two distinct ways. First, by ensuring that work always pays and is seen to pay, they will improve work incentives for people who are out of work. Secondly, by simplifying the benefits system, they will increase the take-up of benefits. It is therefore appropriate to use this Bill to make other legislative changes that allow the Government to take forward their new approach to tackling disadvantage, deprivation and welfare dependency in our society, such as these revisions to the child poverty commission.
	Why is it necessary to make these changes now? We felt that it was important to consult stakeholders before making changes to the commission. We therefore decided to include our thoughts on the commission in our child
	poverty strategy consultation document, which was published in December last year. The consultation closed this February, after which it was necessary to consider the responses before deciding how the commission should be revised. Given that time scale, it was not possible to include the proposed new clause in the original version of the Welfare Reform Bill. Since then, we have set out clearly the changes that we wish to make to the commission and emphasised the need for it to be established as soon as possible. If we had waited for a second-Session Bill to put the required changes to the House, it is possible that a commission would not have been established until 2013, and we do not believe that delay is acceptable.
	I restate that our intention is to move a new clause to the Bill, amending the Child Poverty Act 2010 by inserting a new section 8 and corresponding schedule. The new provisions will extend to England and Wales, Scotland and Northern Ireland. We believe that the motion will give us the opportunity to create a stronger and more effective commission, and I commend it to the House.

Margaret Curran: I thank the Minister for her contribution, and I wish to make a few comments in response. On behalf of Labour I welcome the Government’s motion, and we look forward to the full debate in Committee about the substance of their proposals. However, we are disappointed that we must have that debate in the Welfare Reform Bill Committee, because as she will be aware, a child poverty strategy has been published and there have been a number of criticisms of it. It would perhaps have been better if the commission had been set up first, to inform that strategy. I will return to that point, because that situation perhaps explains why there have been so many comments that the child poverty strategy is insubstantial. I appreciate that the substance of those comments will be featured in Committee, but if I may I wish to make one or two points about issues that the Committee will cover as it examines the Government’s proposals.
	The child poverty commission was a significant element of the Child Poverty Act 2010, which received cross-party support and was regarded as a landmark piece of legislation. It was to be a commission of status and influence, which would be evidence-led, examine different approaches, engage with those with direct experience, harness the experts’ views and, as the Minister indicated, work with the devolved Administrations. I hope that when the Committee has discussed the matter, she will ensure that the commission does exactly that.
	I am sure the Minister is aware of the substantial point that some child poverty organisations have made in questioning the legality of the Government’s approach to date, given the status of the 2010 Act. They say that because the child poverty strategy has been produced before the setting up of the commission, the Government are acting illegally. I hope she will address that point.
	The broadest point that needs to be made is about the Government’s decision to widen the scope of the commission from purely being about child poverty to also embracing social mobility. I appreciate the substance of the argument about social mobility, policy on which underpins any Government action. Of course there are links between child poverty and social mobility, and as I understand it the commission would already have had powers to examine those links. However, the Minister will appreciate that broadening the scope of the commission
	so far has raised many concerns among organisations, and indeed among many Labour Members. There are links between child poverty and social mobility, but they are not the same thing. There is deep concern that including social mobility means that the commission will lose its edge and its focus on dealing with child poverty. It may well dilute the urge to tackle child poverty.
	I have a number of questions to put to the Minister. Given that the matter is now going to the Welfare Reform Bill Committee, may I ask that the commission be established urgently and that there be no further delay? Once its scope has been established, it should go ahead. Will the Minister consult the devolved Administrations on their wider child poverty strategies as a matter of urgency? May we have a guarantee that commitments on child poverty will not be delayed or watered down because of the extension of the commission’s scope to social mobility?
	May we have clarity on what the Government’s child poverty targets actually are? The Minister will know that the Prime Minister made a categorical and unequivocal commitment to maintaining relative poverty income measurements. Can she guarantee that that will still be central to the Government’s proposals? Finally, can she guarantee that the commission will retrospectively examine the already published child poverty strategy so that its fundamental weaknesses can be addressed and we can have an altogether more substantial plan? I appreciate that the meat of the subject will be discussed in Committee, but given that we are making a decision this afternoon on whether to enable the Committee to establish the commission, it would be very helpful if she addressed those points.

Kate Green: I very much look forward to a full debate on the merits of the Government’s proposal in the remaining stages of the Welfare Reform Bill if the instruction is agreed to. However, I cannot wholly share the Minister’s reasoning on why it is appropriate to approach the expansion of the child poverty commission’s remit in this way.
	The Minister said that allocating an advisory role to an arm’s length body would in some way weaken the Government’s accountability. I am confused about why advising should mean becoming responsible, and no doubt she will want to explain that. However, I welcome her acknowledgment of the importance of wide consultation. I hope that that will continue to be the case on the subject of the expanded remit that we are discussing.
	I believe the Minister is mistaken to think that the planned child poverty commission would have had as limited a remit as she seemed to imply. As she acknowledged, the 2010 Act and the functions and remit of the commission had cross-party support, and the Act uses a wide understanding of what child poverty encompasses. That includes a number of the building blocks of social mobility, including on parenting, housing and education, that she seems to suggest would be missed. I hope that she can assure us that when the debate is passed on to the Welfare Reform Bill Committee, with its much narrower remit of considering employment and social security reforms, the vital focus on child well-being in its broadest sense will not be lost. That is what child poverty measures are fundamentally intended to address and improve.
	I agree with the Minister that two central thrusts of the Government’s welfare reform agenda lie at the heart of our ambitions on social mobility. She is right that parental employment is crucial to how we tackle and address child poverty. Unless parents can access employment that genuinely lifts them and their children out of poverty, the child poverty targets cannot be met. She is right, too, to say that the Welfare Reform Bill is an appropriate vehicle for the discussion of child poverty. It is clear that neither child poverty nor social mobility can be addressed unless the right financial support is put in place for families with children. That includes the social security support that the Bill targets directly.
	The reason I mention those two points is that there is considerable international evidence that parental earnings have as much impact on social mobility as other factors such as educational opportunity, and that the most socially mobile and equal countries are those with generous, albeit short-term, social security benefits. That is in striking contrast to the position that tends to pertain in this country and the United States, which is very ungenerous social security benefits that people rely on, in many cases, for quite a long time. It is therefore right that we should debate those issues in the context of the Welfare Reform Bill. In that sense, the Minister’s proposition absolutely stands up. However, this debate also gives us the opportunity to highlight the contradictions and inconsistencies in the Government’s agenda.
	The meat of the Welfare Reform Bill includes issues such as the benefits cap, which will seriously damage families’ well-being, and the reduction in support for child care—we are still waiting in the Welfare Reform Bill Committee to see exactly what the Government will propose, although I think that the Opposition will have concerns about it—as well as access to the labour market for second earners or potential earners in couples and the disincentives that seem to be emerging in the design of the universal credit. They are all issues crucial to child poverty and social mobility, and it is right that they should lie at the heart of the Bill.
	In conclusion, it is right to debate those issues in the context of the Welfare Reform Bill, albeit not just in that context. Doing so gives us an opportunity to remind ourselves that we tackle poverty, inequality and social fluidity not by individualising and pathologising problems, but through the structural solutions that only Governments can provide. Those solutions include ensuring access to education and training, ensuring that parents can access good quality child care, ensuring income adequacy, ensuring the redistribution of income and wealth to reduce the inequality gap, and ensuring the conditions for sustainable, good quality employment that genuinely enables parents to lift their families out of poverty.
	The Government need to be aware that they have at least the beginnings of a credibility problem with those outside this House who are watching and monitoring closely their commitment genuinely to improving the well-being of children and lifting them out of poverty, as the coalition parties, in common with all other parties, last year signed up to do. I very much hope that what we are seeing this evening is not a proposition to marginalise or downplay hard-won gains in securing understanding of the inter-connectedness of poverty, inequality and social fluidity, and, at their heart, the importance of family incomes.

Jennifer Willott: I am not as cynical as the hon. Member for Stretford and Urmston (Kate Green)—I am sure that she does not mind my saying that—although I appreciate that the motion before us is limited and should not be broadened into a big debate about child poverty. There is a great deal of cross-party agreement that tackling child poverty and social mobility is extremely important. There is also cross-party agreement that child poverty levels in the UK are still worrying and that much work remains to be done to improve the situation. Those are areas about which I am sure we will have much more extended arguments in the Welfare Reform Bill Committee. I look forward to having those debates in the next few weeks.
	We have learned that if we are really to tackle child poverty, we need to tackle social mobility at the same time. The two are so completely interrelated that working in silos will not be effective in the long term. It is not enough just to tackle the income coming into families; we also need to look much more broadly, including at the education and work opportunities available to the parents. The hon. Lady made the point about income levels in families, but we know that if children and their families really are to be lifted out of poverty, we need to talk about a lot more than that. I therefore welcome the fact that the Government plan to look at the issues in the round, combining the two areas together.

Guto Bebb: I agree entirely that bringing child poverty and social issues together is important. However, the Child Poverty Act 2010 does not apply in Wales, so we also need certainty that the social mobility elements will be looked at carefully in the Welsh context.

Jennifer Willott: There are issues with child poverty in Wales. The hon. Gentleman and I represent Welsh constituencies. Child poverty levels in Wales are, I believe, higher than in other parts of the UK, just as incomes are much lower. If we are going to tackle the issue in Wales, just as in England and in Scotland, we need to look not just at welfare packages but more broadly at the opportunities available to children and young people, as well as their parents, so that they get the best opportunities. I hope that the Minister will say what she is doing with the Welsh Assembly Government and the Scottish Parliament. We need a lot of co-ordination with the devolved Administrations, because many issues affecting social mobility are devolved matters such as education. If we are to take the issue seriously, we need to ensure good communication and liaison between the devolved Administrations and Departments in Whitehall.
	I look forward to debating the issue further in Committee, but I would be grateful if the Minister responded to a couple of issues this evening. First, can she let us know more about why she feels that combining the expansion of the commission with the proposed change in its remit will increase accountability or ensure that the Government achieve their objectives? For many years Governments have talked the talk, but they have not necessarily walked the walk. I would like the Minister to say more about why she thinks the change will make a difference by delivering good progress on tackling child poverty. I would also be grateful if she gave more detail
	about the timing of the child poverty and social mobility strategies, how they will interact with the establishment of the new commission and how the process will work.
	I welcome today’s proposal and look forward to debating it in Committee in the coming weeks, in what I am sure will be significantly more depth.

Frank Field: Let me add two brief comments to our debate today. The first is directed towards the Liberal Democrats, as I read in the papers that social mobility is an issue that the Deputy Prime Minister is going to take under his wing. I feel in a good mood, so may I offer them some advice? We in this House might know what social mobility means, but if my constituents are anything to go by, nobody out there knows what the hell the Government or the Liberal Democrats are going on about when they talk about social mobility. My constituents all understand the phrase “life chances” and whether the Government have a strategy in place to ensure that every child in this country has a chance to get a better job than their parents, but if we continue to talk about social mobility, they turn the volume down or switch off. Although I do not mind facing the electorate in such circumstances, the policy is too important to allow the Government or the Liberal Democrats to continue to go over the top, shouting language that neither supporters nor enemies can understand.

Jennifer Willott: I completely understand what the right hon. Gentleman is saying. We would all agree that the phrase does not mean very much to most people, but given that it is the jargon that has been used for many years by Governments of all colours, can he suggest a phrase that would be more helpful and productive and that people would understand?

Frank Field: Quite honestly, when we resume debate on the Bill, I would favour the phrase “life chances and poverty” or calling the commission the poverty and life chances commission, because poverty is the aspect that we are trying to break.
	That brings me to the second, perhaps slightly more substantial point that I would like to contribute to today’s debate. When the Prime Minister asked me to conduct and submit a report to him about the foundation years, there was concern on the Opposition Benches that the huge intellectual and political efforts and the resources that the Labour Government had put into trying to tackle and finally abolish child poverty might somehow be dissipated, as though that report would be used as some terrible smokescreen. What is so good about today’s debate is that the discussion has moved on from there. I cannot emphasise enough how much I welcome that. However, I want to suggest that building up the foundation years should become a goal, so that a first building block in any strategy would be for many more children to start their first day of education better able to benefit from that education, rather than have primary schools spending most of their efforts doing rescue work. That has not occurred before. If the Government are concerned with that objective, and also with Labour’s commitment to abolishing child poverty by 2020, initially, in the short run, there is no conflict.
	I draw the House’s attention to a report commissioned by the Joseph Rowntree Foundation that was published a couple of years ago. It looked at what ways are open to the Government if they are serious about reducing the number of children in child poverty as Labour defined that in the 2010 Act. There is a medley of ways, but the one that held the greatest prospect for the quickest advances was building up high-quality child care. As my hon. Friend the Member for Stretford and Urmston (Kate Green) said, if that were in place, many more parents would make the effort to take themselves out of poverty.
	In a not-so-recent letter to the Chancellor, I asked him whether he will make a decision soon on the recommendation in my report. I asked him not to increase automatically benefit rates for children, but to see whether some of that money, in some years, could be better spent on building up the foundation years, as we call them in my report. Clearly, if some of that money were transferred from future years into building up high-quality child care, and if we avoided cutting such provision, as my hon. Friend the Member for Stretford and Urmston said, more children might be ready to benefit from their full-time education from their first day of school onwards. That is the best move the Government can make to reduce the number of children in poverty, year by year.
	I rose to welcome the measure, which takes the debate forward. Hon. Members can get excited about it, but if the Government are serious about talking to our voters, they need to drop the term “social mobility” and come up with a phrase that we can all understand.

John McDonnell: I welcome the proposed instruction to the Committee, on the same basis that my right hon. Friend the Member for Birkenhead (Mr Field) welcomes it. A wider debate on life chances will assist in the tackling of child poverty. I also agree with him on early years provision, although, frankly, we disagree on the method of funding.
	I support the concept of commissions, which was begun by previous Governments. The last one in particular sought to establish a number of standing commissions, and I am glad this Government are doing likewise. I welcome the idea of a standing commission of experts who are free to comment at will—critically at times, but on the basis of objective analysis. That helps the Government, whichever party is in power.
	In its representations, Save the Children raised three anxieties on the commission, and I would welcome a Government response to them—I am sure they will respond positively. First, Save the Children says that it is concerned that the commission could have its powers watered down, particularly in relation to commissioning research and consulting relevant experts and groups. It would be worth while reassuring Save the Children that that will not occur.
	Secondly, Save the Children says that the commission has an important role to play in maintaining the profile of child poverty as an issue. Therefore, it is essential that the commission’s ability to advise and inform the public debate on child poverty remains within its broader remit. Once again, it would be worth while Ministers giving that assurance to Save the Children. Will there be
	full publication and openness and transparency? Will the commission have the ability to publish independently, without Government interference?
	Thirdly, on life chances and social mobility, Save the Children would like us to examine and explore the Government’s thinking on the expertise they will seek to bring on to the commission. Once again, the Government could reassure the poverty lobby on that. If the proposals are amended in that way, the commission will undertake a worthwhile exercise, be open and transparent, and contribute to and heighten the profile of the wider debate on child poverty.
	I agree with my hon. Friend the Member for Stretford and Urmston (Kate Green) about the Government’s solutions to the problem, because some Government policies are driving more children into poverty, but at least we can agree that we need a commission that will provide research and independent advice so that we can have an informed debate. On that basis, I welcome the instruction.

Margaret Curran: With the leave of the House, Mr Deputy Speaker, may I make one or two comments in response to the debate, and thank hon. Members for their contributions? I will not go through them all, because I might overstretch my opportunity.
	My hon. Friend the Member for Stretford and Urmston (Kate Green) made the important point that connecting welfare and welfare measures is at the heart of tackling child poverty. I hope that when we get to the substance of the debate we examine the proposals for universal credit, which are a substantial change in the welfare system.
	I always listen to my right hon. Friend the Member for Birkenhead (Mr Field) on these matters, and I will continue to do so. He commented on the centrality of child care, the child care proposals, and the impact of the introduction of universal credit, which is enormously significant. Regrettably, the Government have not fully clarified what will happen in respect of child care, which goes to the heart of the commission’s work. I hope that the commission examines that aspect as well.
	Finally, in response to a number of points, I understand the arguments, but we cannot lose sight of the fact that defeating the scourge of child poverty is a central part of Government work. We cannot afford to lose that focus. I take the point made by the hon. Member for Cardiff Central (Jenny Willott) on the consensus that has been established to deal with that scourge. Let us not lose that. Irrespective of other matters, we must target, measure and take action to tackle child poverty. I hope the widening of the commission’s scope will not dilute that, and I look forward to substantial and lively debates in Committee.

Maria Miller: With the leave of the House, Mr Deputy Speaker, I should like to respond to some of the comments made in the debate, and first of all to thank the hon. Member for Glasgow East (Margaret Curran) for her support for the motion. It was interesting and useful to
	hear the comments of right hon. and hon. Members in this debate, and I am grateful for the points that they have raised.
	The right hon. Member for Birkenhead (Mr Field) raised an important point on the language that we use to describe such issues to people who perhaps do not live and breathe them in the same way that we do. That is important, but it is not, along with a number of issues raised by hon. Members, fully within the scope of today’s debate. We should debate such things in Committee, on Report or on Third Reading.
	Tonight’s motion is on extending the scope of the Bill to enable that debate, and I am glad that so many hon. Members agree that the measure is appropriate. The right hon. Member for Birkenhead spoke of the importance of child care and getting full responses to his report, particularly on the early years. I remind him and hon. Members that we are committed to consulting on various options on child care and universal credit, although I am asking your indulgence, Mr Deputy Speaker, in straying that far.
	The hon. Member for Glasgow East made a number of points, and I hope to cover a few of them. I point her and other hon. Members who commented on the broadening of the commission’s role to our consultation on the various ideas in our child poverty strategy. I remind them that we received 280 responses to that consultation, which was more than those received to the consultation on the original Child Poverty Act 2010. Only around 6% of people who responded felt that broadening the commission’s role was inappropriate. That shows that people understand the value of broadening the issues that are examined when we address child poverty, and that we cannot view children in isolation from either their communities or their families. Hopefully, hon. Members understand and agree with that.
	The hon. Member for Stretford and Urmston (Kate Green) made a number of important points. She asked whether the Government remain committed to the 2010 Act. I should like to say a very clear, loud yes to that. The Government are clearly committed to the income targets in the Act, but as I outlined and as I am sure she will agree, tackling child poverty is not just about lifting people above an arbitrary income line; it is about ensuring that they have the support, incentives and skills necessary to create a better life for themselves. I hope that she would also agree on the importance of incorporating that principle into the commission’s work. We are looking at the root causes of poverty, not simply dealing with its symptoms and moving finances and moneys about.
	My hon. Friend the Member for Cardiff Central (Jenny Willott) raised a number of issues, but I would particularly like to pick up on the one about how tackling child poverty is about more than income. She has my wholehearted support for her sentiments. Using targets in isolation has in the past focused policy on short-term solutions, leading to vast sums of money being spent on financial support without fundamentally changing the causes of poverty. I welcome her support for our approach and the opportunity that will no doubt be afforded by her membership of the Welfare Reform Bill Committee to debate the detail and substance of some of the issues she raised.
	The hon. Member for Glasgow East talked about the broadening of the commission—in fact, this was also raised by the hon. Member for Hayes and Harlington
	(John McDonnell)—and was worried that we were diluting the powers of the commission. I would challenge that; we are doing quite the opposite. We are actually reinforcing the commission’s powers by giving it the opportunity to range more broadly over those issues that really affect the life chances of young people in this country. The commission’s duty to report annually on progress towards reducing child poverty will ensure that the issue remains high on the Government’s agenda, and I am sure that nobody needs reminding that it is also in our coalition agreement.
	The hon. Member for Hayes and Harlington mentioned the expertise on the commission, which might be an issue that we can discuss in Committee or perhaps on the Floor of the House on Report. One reason we believed that it was important to move to a child poverty and social mobility commission, rather than simply remaining with the legislation as it was, was precisely the one he raised: we wanted to ensure that that broader expertise was put in place.
	Many other issues have been raised today, but I want to touch on just one more before I close. Hon. Members asked why we believed that the reformed child poverty commission would be more powerful, and why it mattered that instead of having an advisory function, its role should be to hold the Government to account. We believe fundamentally that Ministers are responsible for the strategies put forward. However, section 10 of the 2010 Act clearly allows the Secretary of State to devolve to the commission responsibility for establishing a strategy or to act on advice in a way that could place on it responsibility for that strategy. This is really important and is at the heart of the coalition Government’s approach to ministerial responsibility. We do not believe that the commission should be responsible for the strategy; that is the role of Ministers. That is one of the fundamental changes that we are making, and it will ensure that the role of the commission is to hold us to account for the work we are doing. We do not want to defer responsibility to a commission that after all is not accountable at the ballot box. That is one of the important changes we have made.
	In conclusion, we believe that these changes will ensure that the commission is an effective and efficient public body with the necessary powers to fulfil its duties and to hold Government properly to account. Moreover, they will remove the requirement on the commission as currently defined. It is a public body that cannot provide the taxpayer with value for money. There will be further opportunities to debate the content and detail of some of the issues raised today as we move through the various stages of the Bill. However, I hope that I have reassured hon. Members that allowing these changes is both necessary and beneficial to the cause of tackling child poverty, and I commend the motion to the House.
	Question put and agreed to.

Trafficking in Human Beings

[Relevant document: T he Twenty-fourth Report from the European  Scrutiny Committee, HC 428-xxii.]

Damian Green: I beg to move,
	That this House takes note of European Union Document No. PE-CONS 69/10, relating to the Directive of the European Parliament and the Council on preventing and combating trafficking in human beings and protecting its victims, replacing Council Framework Decision 2002/629/JHA; and supports the Government’s intention to apply to opt in post-adoption under Article 4 of Protocol 21 on the position of the UK and Ireland in respect of the area of freedom, security and justice.
	I thank members of the European Scrutiny Committee for giving us the opportunity to set out why the Government wish to opt in to the EU directive on human trafficking and the benefits it will bring to the UK. I hope that this debate will secure the Committee’s support for this important measure, which I believe further strengthens the UK’s position on tackling human trafficking. I also welcome this debate as a step forward for parliamentary scrutiny. We welcome the Committee’s consideration of the Government’s intention to opt in and its detailed report, in which the Committee acknowledged that the objective of preventing and combating trafficking cannot be sufficiently achieved by member states alone and can, by reason of both its scale and effects, be better achieved by action at EU level. Our intention to opt in is consistent with that view.
	I know that Committee members recognise that human trafficking is an abuse of human rights that feeds on the exploitation of victims—men, women and children. The victims of this appalling crime are mere commodities in the hands of organised crime groups, and their exploitation causes severe and lasting harm. We are clear that tackling this crime is of the highest priority. Human trafficking is a complex, covert and cross-border crime that demands an international response. The UK is a world leader in its anti-trafficking work, but that does not mean that we should stand still. Rather, we have a responsibility to lead the way in the fight against trafficking and develop increasingly sophisticated responses to the changing nature of the organised crime landscape.

Keith Vaz: Does the Minister welcome the recent developments in the EU that will provide for more border checks within the Schengen area? When the Select Committee on Home Affairs last reported on this, it found that traffickers could pass through the Schengen area without being stopped. These new arrangements, which the EU seems to be putting in place, will mean more checks within the area, which might mean that we catch more people involved in this terrible crime.

Damian Green: The right hon. Gentleman might well be right. However, it would be unhelpful for me to comment generally on the developments in the Schengen area that, as he and the House will know, might be introduced as a result of events in north Africa. Certainly, however, I agree with the general proposition that each EU member state has to consider its own border arrangements and internal policing arrangements to make it easier for all of us to work together on an international basis in combating what is by definition
	an international crime. That means that to deal with this problem we have to work closely with our international partners, and applying to opt in to the directive is a positive step that Britain can take towards this goal.
	As the House will be aware, we chose not to opt in to the directive when it was initially put on the table last summer, because the draft text had to go through an extensive period of negotiation between the European Council and the European Parliament. We wanted to be absolutely sure that the text would not change during those negotiations in a way that would be detrimental to the integrity of the UK’s criminal justice system. We wanted to consider a final text that had no risks attached and would not fundamentally change the UK’s already strong position in the fight against human trafficking.

Mark Tami: Does the Minister not think that it sends a negative message that we have taken so long to sign up?

Damian Green: No, I do not, because once the text was available, we looked at it and made the recommendation very quickly, so there has been no practical delay at all. We have examined in great detail the final text and its impacts on the UK, and have concluded that applying to opt in would benefit the UK as well as—most importantly—the victims of trafficking. Applying to opt in to the directive will maintain our position and will continue to send a signal to traffickers that the UK is very serious about tackling trafficking.
	I am absolutely clear, however, that merely applying to opt in is not enough. We have much work to do to ensure that the directive is implemented in an effective way across the UK. There has been great interest in how we will implement certain measures in it, which I will deal with in a moment. The UK already complies with the majority of its measures. We have said from the outset that opting in to the directive will require us to make some legislative changes to ensure full compliance, and we are ready to do that. This will include widening extra-territorial jurisdiction. The directive requires us to establish extra-territorial jurisdiction when the offender is a UK national. It also gives us discretion about whether to establish jurisdiction over cases in which the offender is an habitual resident.
	I know that that issue has caused much debate; another is that of child guardians. On this, the directive contains a number of important provisions about assistance and support for child victims of trafficking. We are confident that the UK is compliant with those measures. Local authorities have a statutory duty to ensure that they safeguard and promote the welfare of all children, regardless of their immigration status or nationality. We believe that this responsibility should remain with the local authorities that co-ordinate the arrangements for each child to ensure that they are safe and to promote their welfare.

Margot James: Does the Minister agree that local authorities are going to need some training, direction and guidance on this matter? The record of child victims of trafficking disappearing from local authority care very soon after their admission is shocking and disturbing.

Damian Green: I agree that there have been severe difficulties in that regard. My hon. Friend will know that there tends to be a concentration of child victims of trafficking in certain local authorities, and one of the things that encourages me is the way in which local authorities—particularly those that are the most affected—are now learning best practice from each other and getting a grip on the problem of disappearance, which has afflicted many child victims of trafficking. For instance, Hertfordshire has, by adopting new systems, reduced the number of children who disappear from 36 to two in 12 months.
	Great improvements are clearly needed, but we have already seen them being made in some local authorities, which are developing the kind of systems that are effective in enabling them to fulfil their statutory duty to protect children. They have comprehensive systems in place to do this, and adding another guardian to that framework would risk creating another level of complexity in arrangements that are already strong and that ensure the best interests of the child. Even worse, it would risk creating confusion for children themselves if plans for their care were not effectively co-ordinated.

Tom Brake: What would be the difference between having an independent reviewing officer and advocate, and having a guardian? Is it the Minister’s view that the combination of an IRO and an advocate amounts to a guardian?

Damian Green: That is exactly my view, and having another guardian would be confusing and potentially bureaucratic. Indeed, in discussions with the very energetic all-party group on human trafficking, one of its leading officers, the noble Baroness Butler-Sloss, made the point that when the directive talks about a guardian, it does not, in her view, mean a guardian ad litem—a legal representative of the child—who would deal with the courts, as happens in “normal” child protection issues. The truth is that the concept of the guardian in the directive is slightly vague, and slightly declaratory, and we believe that our present system is already achieving what the directive wants us to achieve.
	Another provision that has generated great interest is the idea of a national rapporteur on human trafficking. Again, we believe that we have equivalent mechanisms in place that fulfil that purpose, in the form of the UK Human Trafficking Centre, for data collection, and the inter-departmental ministerial group, for oversight. I recognise the concerns expressed by hon. Members and others that this function should be carried out by an independent body, and I will keep those arguments under consideration.

Andrew Selous: I congratulate my hon. Friend on these measures, which are welcomed by many of us. Will he tell us what new police initiatives he envisages as a result of the motion, given the evidence of the success of Operations Pentameter 1, Pentameter 2 and Golf? Focused police effort has made a major difference.

Damian Green: My hon. Friend is right to say that good things were done during the focused police action under the two Pentameter operations. One result is that
	combating trafficking has become much more a part of mainstream police work than it was a few years ago. There will be further developments on the activities of the national crime agency and, more specifically, on the new trafficking strategy that will be announced in the coming weeks. I will come to that in a second, if he will excuse me.

Peter Bone: I absolutely welcome the Government’s decision to opt in to the directive, as does the all-party group on human trafficking. We are concerned, however, about the Government’s decision on the rapporteur. I am all European and I like that sort of thing, and I hope that the Government have not closed their mind to the idea. I do not think that the mechanism that the Minister has outlined is good enough.

Damian Green: I am sure that the whole House will echo my pleasure at my hon. Friend welcoming this opt-in to a European directive. I cannot say how delighted I am to be on the same side as him in this argument. As I have said, I will listen to the arguments about an independent rapporteur, but I would merely observe that only two EU countries have adopted the mechanism that he favours. It is therefore reasonable to say that the jury is out on whether that is the most appropriate way forward.
	I want to be clear that applying to opt in to the directive is only one part of the wide range of work that we are carrying out to tackle trafficking. Despite the difficult financial climate, we have protected funding for adult victims. We have set aside £2 million a year for the next three years to fund support provision for adult victims of human trafficking. As part of our wider work to tackle trafficking, we have introduced a new model for funding specialist support for adult victims. This will ensure that each identified victim receives support tailored to their individual needs and in line with the standards set out in the Council of Europe convention. It will also ensure effective co-ordination and monitoring of the support on offer, while enabling a greater range of service providers to support victims of this crime. These changes will result in a more comprehensive system of care that will take better account of the particular needs of individual victims. The flexibility of the new model will also mean that we are better equipped to meet the victim care requirements contained in the directive.
	The strategy on human trafficking will set out in more detail the direction of our work on trafficking, and this will be published shortly. As I have just mentioned to my hon. Friend the Member for South West Bedfordshire (Andrew Selous), the strategy will set out the steps that we will take across four key areas: disrupting trafficking networks before they reach the UK; smarter multi-agency working at the border; more co-ordination of our law enforcement efforts in the United Kingdom; and improved victim care arrangements. As I said during the anti-slavery day debate in the House last October, the strategy will maintain the focus on victims and also put renewed effort into upstream enforcement, without compromising in any way our commitment to victim care. We will continue to work with a range of partners to achieve this. I hope that the House will support the Government’s intention to apply to opt in to the directive, and I commend the motion to the House.

Fiona Mactaggart: I welcome the Government’s decision. We asked for it some 40 times before they decided to do it, but that does not make the decision any less welcome. It is a recognition of the need to work between countries in this area of international abuse of human rights. Getting more effective collaboration between countries is critical if we are effectively to drive down the extent of human trafficking.
	I genuinely welcome what the Government have done, but I think there is still a gap between refining the law, creating the right procedures and perfecting the administrative procedures that happen on the ground. If we look at our record on apprehending traffickers, we find that the numbers apprehended remain unconvincing. There is a huge gap between the estimated number of traffickers and the number of prosecutions. Victims largely remain invisible unless they are uncovered as a result of raids. Some victims have been identified through the national referral mechanism, but I am concerned about the way in which the NRM seems to have an attrition rate of about 50% after the initial recognition and 50% on the final recognition. Every organisation working in this field believes that a huge number of victims have not yet been identified.

James Wharton: Does the hon. Lady agree that although, as we heard from the Minister, there are hotspots around the country, there is a danger of forgetting that this can be a problem absolutely everywhere? There is a great deal of unreported trafficking in areas that might not be hotspots but still need to be the focus of Government attention.

Fiona Mactaggart: The hon. Gentleman is absolutely right. I fear that I probably represent a hotspot—one of the few constituencies in which successful prosecutions for child trafficking have been launched—yet I recall hearing a police officer from rural Dorset talking about his experience of finding in a local brothel women who had been trafficked. Police officers involved in the post-Ipswich work were shocked at the number of trafficked women they found in brothels in very nice parts of East Anglia. I think it is clear that this is happening all over the country and that we are not yet drilling down to the bottom of the problem. I know that trafficking is not just an issue across international borders, as it also occurs within the UK. I welcome the fact that the directive reflects that, so that we will be able to deal with internal trafficking around the country, which is a critical issue.
	My concern is that, without targets—Pentameter 1 and 2 provided them—the police do not have sufficient incentives to deal with the problem. I agree with the Minister that it is becoming more mainstream police business, but I also know that some police forces have not learned what we have just been reminded of by the hon. Member for Stockton South (James Wharton)—that the trafficking is happening here. It is not given sufficient priority and many victims fail to be identified.

Mark Tami: Is my hon. Friend concerned, as I am, about the level of cuts to the police forces, particularly in areas such as port security, where traffickers probe for a weak point when they are bringing people into the country?

Fiona Mactaggart: My hon. Friend is absolutely right. Under Pentameter 2, an expert team was set up at Heathrow, which was able to identify children who came through the airport without their parents, as they were particularly vulnerable. That team is not replicated at other ports of entry, and there seems to be compelling evidence to show that Eurotunnel is a route increasingly used by child traffickers because that same kind of expertise is not deployed to identify and interdict child trafficking at the port.

Peter Bone: The hon. Lady is making a powerful speech and knows a lot about the subject. Would Her Majesty’s Opposition support the Government in respect of the border police, as one of its roles is to make sure that trafficked victims are not brought in through our ports?

Fiona Mactaggart: The Opposition will support any effective border measures that help to protect this country’s borders against illegal immigration and to prevent the victimisation of people through trafficking. We are absolutely on side when it comes to both those things. The targets that existed under previous nationally initiated police operations are, in my view, necessary to make this kind of work, which I welcome, operate effectively.
	Another theme in the directive is the importance of looking after victims. I am concerned about the recent decision to replace POPPY as the provider of victim care. I think that the POPPY project was the most exemplary pioneer in its work on victim care. One thing it was prepared to do because of its independence was to challenge decisions on behalf of victims who were not identified as victims by the national referral mechanism. Will the Minister give a guarantee that the present arrangements for providing victim care will include a willingness to act on behalf of those victims who have not been identified by what amounts, frankly, to a bit of a tick-box exercise when it comes to the questionnaires issued by the NRM? Will the new victim care arrangements allow decisions by the NRM to be challenged so that people who have not been designated as victims of trafficking can be properly protected?

Margot James: I share the hon. Lady’s admiration for the work of the POPPY project. There is no doubt about the excellence of its organisation. It was, however, in receipt of nearly £1 million for doing its work. Does she accept that it is worth at least trying to allow the new organisation, which will provide care for more victims with the same amount of money—we have heard that the actual amount has been increased, but pro rata I believe it will provide care for more—to get on with its job?

Fiona Mactaggart: That is what the contract requires of the new organisation. I did not make any criticism of it because I wish it well. It has the job now, although I am sad that POPPY’s talent might be lost as it had powerful experience to bring to bear on the problem. I asked for a specific assurance that the new organisation will be allowed to challenge—and provided with the finance, perhaps retrospectively—in cases where its advisers and support staff believe that a decision by the NRM has been inaccurate. I put that question to the Minister and I am sure he will come back to it in his reply.
	I accept that we need value-for-money services. Personally, I thought POPPY provided pretty good value for money for the women victims whom it supported and I hope that the new arrangements will provide a similar quality of support for women, which is gender sensitive and so forth. I know that part of the ambition was to extend it beyond trafficked women to male victims of trafficking—an initiative that I welcome—but I hope we will continue to have the gender sensitivity that is required in the directive and that POPPY so exemplarily displayed.

Crispin Blunt: As the Minister who announced the result of the competition this morning, I want to make it clear that although the Salvation Army, which won the contract, will expect to administer directly about 25% of the funds made available by the Ministry of Justice, 75%—£1.5 million a year—will remain available to organisations such as POPPY so that they can provide the services that they have provided in the past. Although the Salvation Army has taken over the leading role, it will not do all the work itself, and we will need to use the expertise of organisations such as POPPY.

Fiona Mactaggart: As the Minister knows—because we have discussed the matter before—POPPY did bid for the provision and his system did not approve the bid. It is quite possible that the requirements that the Salvation Army will lay on the organisation to which it subcontracts will not be appropriate for POPPY. As the Minister knows, POPPY had to bite its tongue a bit to make the bid in the first place, and I encouraged it to do so. We cannot be certain that it will be able to continue—or afford to continue—to provide a service of this kind.
	The Minister for Immigration referred to the rapporteur requirement in article 19. I welcome his recognition that—notwithstanding the memorandum that he supplied to the Committee, according to which this was provided by the United Kingdom Human Trafficking Centre and the inter-ministerial group on human trafficking—there is a question to be asked about whether some more independent mechanism might be appropriate. I strongly urge him to adopt that route, and I am glad that he has left the door open.
	I believe that the inter-ministerial group has met once since the election of the present Government. I do not think that that suggests a great degree of oversight. It also worries me that UKHTC does not provide public reports of its work or accessible statistics. In contrast, the Child Exploitation and Online Protection Centre, which is part of the same mechanism, provides detailed figures and reports which enable it to hold the body to account. I think that we need a body which will report to this Parliament, and which will provide it with the necessary figures and details.
	I talked recently to representatives of ECPAT, an exemplary organisation that supports child victims of trafficking. They said that the most recent figures they could get out of UKHTC did not break down the details of victims of trafficking—even children—according to nationality and age, which would have enabled them properly to understand how that ghastly phenomenon operates. I urge the Minister to establish a mechanism which can report to Parliament, and which recognises that the job of a rapporteur is not to administer but to
	find information and report it. At present, the bodies to which he refers in his memorandum do not go in for much reporting.
	Finally, let me deal with the issue of child victims. Shortly before the debate, a number of members of the all-party parliamentary group on human trafficking heard an excellent presentation by Barnardo’s about its work with children who have been sexually exploited. Some have been trafficked, and some are victims of a sexual exploitation of a kind that has parallels with child trafficking. Barnardo’s estimates that there are 1,000 sexually exploited children in Britain today, and that the experience of those children, when they come into contact with the criminal justice system, is of being criminalised rather than treated as victims. I believe that Members on both sides of the House feel shame about that.
	There is an urgent need for us to provide proper protection mechanisms for child victims of trafficking, and that will require, among other things, a proper guardianship system. We know that although, in theory, local authorities take responsibility for the welfare of children, that is not always the case in practice. The Minister mentioned some good practice in Hertfordshire, which we welcome, but, as he is aware, that is the exception rather than the rule. We know that trafficked children disappear from local authority care every week, and that, rather than being found a few weeks later, they are never found. It is horrific that those most vulnerable, most exploited children are not being protected. It is not just a question of protecting them against an uncle, or whoever is trying to instruct a lawyer on their behalf when it comes to criminal proceedings; it is also a question of protecting them against continuing re-trafficking, which, as is fairly clear, is unfortunately what is happening to many children in Britain today.
	Signing the directive would give Britain an opportunity to make a real difference, but we need a practical strategy to implement its proposals. We were promised that in the spring, and the Minister referred to it again tonight, but progress seems to be at best confused, and at worst even more confused. It is slow and a bit muddled. I have been told by voluntary organisations that have been consulted about what the strategy might include that different Home Office civil servants have been put in charge of it, that meetings keep being arranged and then cancelled, that people are not given papers before meetings, and that the timing of a meeting that was due to happen the following day is changed and no agenda is circulated.
	I believe that the increasing number of voluntary organisations that deal with human trafficking—including the excellent Human Trafficking Foundation, which was created by a former Member of Parliament for Totnes—are beginning to feel that the Government are trying to use them as a free research resource without listening to their concerns. We want the strategy, and we want it to be as specific as the last strategy—which, I note, has disappeared from the Home Office website, and which had the benefit of specific targets.
	I hope that the Minister for Immigration will be able to reassure us that there will be proper consultation about the strategy, that voluntary civil society organisations will be involved as is required by the directive, that they will be properly involved and not asked to attend meetings without an agenda, and that the strategy will be not
	merely a high-level document with no specific facts and figures enabling people to be held to account, but a concrete set of promises. It is time that we had such a strategy. It was promised for the spring, and my gardening practice tells me that the spring is very nearly over.
	Let me end by welcoming today’s decision, which I am sure the whole House will support, and by urging the Minister to do more to make the provision work well in practice. He has some of the necessary ideas, but we need to ensure that they are implemented.

Tom Brake: I am very pleased that we are having this debate. The fact that we are doing so is a tribute to Members on both sides of the House and others, including the Minister for Immigration, the Home Secretary, the members of the all-party group on human trafficking, Anthony Steen and the hon. Member for Slough (Fiona Mactaggart). It is a collective achievement, therefore.
	As Members will know, in Europe alone the estimated value of trafficking is £3 billion, and about 140,000 people are being held in conditions of effective slavery in Europe. This morning, I had a meeting with Croydon Community Against Trafficking, which has done very good work in identifying brothels. From its research, it concluded that there were 65 brothels in Croydon. It passed that information to the police in Croydon, who had identified only eight brothels. This shows the scale of the problem we are facing both in European terms and at the local level, and it highlights the fact that human trafficking, especially for the sex industry, is a significant issue.
	I want to thank the Home Secretary again. We have had an extensive exchange of correspondence on this matter over the past three months or so, and there are a couple of points on which I seek clarification relating to the impact the EU human trafficking directive will have in the UK and any additional measures the Government might intend to take. When I intervened on the Minister on the topic of guardians, he said he was confident that the combination of an independent reviewing officer and an advocate was, in effect, a guardian or the equivalent thereof. I am sure he is right, and I hope so too because when we have to respond to the petition on guardians with 600,000 signatures that ECPAT is apparently going to be handing in on Thursday 12 May, it will be much easier if all Members can collectively say that the matter has been addressed. It will save us a significant amount of pain if we are in a position to say that.
	It is my understanding that forced begging is already a crime in the UK. I ask the Minister to clarify either now or later whether a comparable legal penalty is attached to that, and whether as a result of the implementation of the human trafficking directive we will follow other countries in recording the figures for forced begging so that we can draw straight comparisons. In my mind at least, there was also some confusion as to whether other offences that are not currently covered in the UK are addressed by the directive and therefore whether we might now have other offences as well as forced begging.
	Victims of trafficking receive free medical care, but what support in respect of accommodation, and especially safe accommodation, is there, and does the Minister expect that to be provided to all victims?
	On the protection of victims in criminal proceedings, the Home Secretary confirmed that special measures such as witness protection and anonymity are not guaranteed, but are granted on a case-by-case basis. I hope the Minister can give some reassurance that they will be available in cases where that is clearly necessary. Also, there is a suggestion in the response that if legal aid is not available, victims should seek help from non-legal professionals or legal voluntary organisations such as citizens advice bureaux. Given the nature of these crimes, will the Minister consider whether victims should, in fact, receive proper legal support when they require it?
	I referred in my opening comments to Croydon Community Against Trafficking, and I congratulate that voluntary organisation on the work it is doing. Following promptings from Anthony Steen, it is trying to expand its network to all the London boroughs. Many of its activities are based on following leads from adverts as they appear in newspapers. I am sure that Members will welcome the fact that Newsquest—which produces many of the local newspapers around the country, including my own, the Sutton Guardian—has given a guarantee that it will not carry these ads. That is not the case for others, however, such as the Advertiser group. I am afraid that on occasion its papers are in the bizarre situation of featuring on the front page articles about raids on brothels that have resulted in their being shut down, while on the back pages carrying adverts for the services of those brothels. I hope the Minister will address that. He has welcomed the actions of Newsquest, and I wonder whether he might like to put a challenge to other newspaper groups in respect of the adverts they continue to carry.
	I also ask the Minister to set out how he sees the time scales developing from now on, in respect of any other measures that might be taken or hoops that might have to be jumped through, before we can finally say that the EU human trafficking directive has been adopted in its entirety and we can once again commend all the actions that have collectively been taken to ensure this becomes part of the UK’s legislation.

Keith Vaz: As always, it is a pleasure to follow the hon. Member for Carshalton and Wallington (Tom Brake) in a debate on human trafficking. He served with distinction on the Select Committee on Home Affairs a few months ago when we published our report into human trafficking. That took over a year to complete, not because we were not seeking to inform the House more quickly, but because the more we investigated this very important subject, the more information came before us and the more we wanted to get to the bottom of the root causes of human trafficking.
	This is a unique debate because Members on both sides of the House are lavishing praise on the decision of the Minister and the Government. That is an unusual situation for the Minister for Immigration, which he should appreciate and put in the bank for future occasions. He and the Government have done absolutely the right thing in opting into this directive. It will make a huge difference in respect of our uncovering the sources of human trafficking and dealing with those criminals who make such a vast amount of money—£32 billion worldwide, which makes trafficking the second largest
	illegal industry after drugs. If as a result of what the Government are doing today we catch more of these criminals, signing in will be worth it.
	It is right that we pay tribute to Anthony Steen for the work he has done for many years. Even though he is no longer a Member of the House, his spirit lives on in the all-party group and I am sure he is watching the deliberations of the House today and that tomorrow I and other Members will be getting an e-mail pointing out all the things we should have said on this matter and all the things he feels we can help him with in the future.
	I pay tribute to the hon. Member for Wellingborough (Mr Bone), who took over as chairman of the all-party group and has done a fantastic job in ensuring this issue remains at the forefront of the work of Parliament. Given his views on Europe, he is going to make a piece of incredible parliamentary history today in supporting an opt-in to something that has been proposed by the European Union. We should not forget this important piece of parliamentary history. We will hear from others involved in tackling trafficking, and may I say what a good thing it is that the House is relatively full for this time of night?
	As has been said, this is of course an issue for this country, but we need primarily to go to the sources of human trafficking to try to find out why and how people are trafficked. As part of that, we need to examine the developments in the European Union, and I raised that issue when the Minister spoke just now. The recent developments on the Schengen arrangements will help us to try to catch some of these criminals. This country is, rightly, not part of those arrangements, so we are observers and we have no direct interest in those matters. We are not the decision makers—this will be done without the United Kingdom’s involvement—but of course we are the beneficiaries of any changes to the Schengen arrangements that mean that the borders of Schengen countries are protected and measures are in place to ensure that those who seek to use the freedom of movement in the European Union for criminal purposes, be it illegal immigration or human trafficking, are checked very carefully. I hope that, although we are only observers, the Minister and the Government will make relevant comments to our colleagues in the European Union about how these measures will affect not only illegal immigration, but, more particularly, because of the nature of this debate, the way in which we deal with those involved in human trafficking. These measures are not an end but a beginning and this Government, Members of this House and others have a constant desire to make sure that we are vigilant against those who are trafficking people.

Justin Tomlinson: I have spoken in debates on this subject before and I must say that a lot of the trafficking goes unnoticed. It is now being targeted in new development areas that have a high prevalence of rented property, where people cannot name their neighbours and do not necessarily spot anything untoward when people come and go at early hours. We need to be vigilant in our communities to ensure that we are feeding that information to the police and the local authorities.

Keith Vaz: The hon. Gentleman is right about the need for vigilance. We sometimes talk about trafficking as if it were a global problem—and of course it is—but
	it is found in our neighbourhoods. It is a problem for local communities and we need to collect that information and make sure the police are in a position to act on it. In a real sense, this is a neighbourhood watch issue; it is about whether people are prepared to spot what is happening locally and report it to the police.
	During the recess, I took the opportunity to visit Tandarei, in Romania. I felt that I had got closure, because I had been trying to do that for a number of years, including with my Select Committee. We had heard about this town in Romania that had been transformed because of the money that had been sent by children who had been begging on the streets of London, Madrid, Paris and other major European cities. We received the co-operation of the Romanian Government, and I wish to pay tribute to the excellent work that they have done. I also wish to pay tribute to the work of the Romanian police, in concert with the Metropolitan police, on Operation Golf, which was mentioned by the hon. Member for South West Bedfordshire (Andrew Selous), who is no longer in his place. That international co-operation goes beyond directives of the kind that we are discussing, but the close co-operation of the Metropolitan police and the Romanian police led to many people being arrested in Tandarei.
	In Tandarei, we saw a number of very expensive villas that had been built as a result of the proceeds of trafficking and a number of very expensive cars. We spoke with the mayor and other officials there and I must put on the record the fact that they, of course, denied any involvement in human trafficking and denied that children were being sent from this remote Romanian village to London, Madrid, Paris and other major cities. However, they did say that money had been flowing into Tandarei. The figures that we were given showed that £2.8 million had been transferred through legitimate means—through Western Union and by other means of transferring money—into that town last year, and it is estimated by the authorities that many millions more had gone there. Those who live in that town have said that the children go voluntarily, with the consent of their parents, to raise money for the betterment of their local communities. We therefore have a duty to engage with these communities, through the excellent work of the Romanian authorities and the Romanian Government, to try to explain that this is not the right thing to do with young children and that the best place for them is with their parents and families. As neighbours, partners and colleagues in the European Union, we should also provide whatever help is necessary.
	Some people may think that this problem cannot be solved, but I think that it can. I believe that this will be solved by going to the source countries, such as Moldova, a third of whose population has left that country over the past 10 years, and origin countries in north Africa from which people are being trafficked. We have read the stories of those who are now coming from Libya, some of whom are paying huge sums to get out of that country. Some of them end up in Italy, and I spoke this morning to the Italian ambassador about the problem. Last week, I spoke to the Greek ambassador about the number of people from Moldova and Afghanistan who end up in Turkey. Many of those people have just one ambition, which is to live in the United Kingdom, and they will pay any amount of money in order to do so.

Mark Spencer: A lot of tonight’s debate has focused on the supply and the trafficking, but does the right hon. Gentleman agree that we need a double-pronged approach and that we should also put emphasis on those who use these establishments? Does he agree that the police and local authorities need to educate and prosecute the people who make use of these establishments?

Keith Vaz: The hon. Gentleman is right. Of course, the previous Government introduced legislation making it an offence for someone to engage in sexual relations with someone who may have been trafficked. We had a debate about that and it is an absolute offence. He is right to say that we must limit the supply by intelligent policing and co-operation, and that we must reduce the demand by being very firm on those who are part of that system—he leads me to an excellent place to end my speech. If this Parliament can do that and if the Government can opt into this directive, we will have moved a step closer to eradicating this terrible, terrible problem.

Peter Bone: It is a great pleasure to follow the right hon. Member for Leicester East (Keith Vaz) and, as usual, I agreed with every word he said. I very much appreciate his kind words about me and, in return, I shall say that the work of the Home Affairs Committee under his chairmanship is most welcomed in this field.
	It would be wrong of me to start without mentioning the two excellent Ministers on the Treasury Bench, the Under-Secretary of State for Justice, my hon. Friend the Member for Reigate (Mr Blunt), and my hon. Friend the Minister for Immigration, who have played an important role in bringing us to where we are tonight. They have both had the time and the patience to talk to the all-party group on human trafficking and we appreciate that.
	I welcome the directive and I should also congratulate the previous Government, because, on a non-party political basis, we are building on their work. They took us into the Council of Europe convention on action against trafficking in human beings, which is now being embodied in EU law. The all-party group, under Anthony Steen, did much in the previous Parliament to push that Government in that direction and it is the role of our group to continue to push this Government. Although we welcome the debate and will lavish praise on the Government tonight, we will return to particular points and push the Government hard. My great concern about the EU directive, which I have expressed on many occasions, is that it must be seen as the minimum, not the maximum. We must go much further than it does.
	For me, the great thing about opting into the directive is that it sends a message to EU countries that in this country we are serious about the problem, which will encourage other EU countries to do more. We cannot stop human trafficking on our own; we must work with our European neighbours to stop it. To that end, I am pleased with the all-party group’s initiative to try to set up similar all-party groups in other parts of the EU. We have obtained a grant from the EU to do that.
	I praise both Ministers for the decision on victim support. The Under-Secretary has not blown his own trumpet enough tonight, as, at a time when there are
	cuts, it is quite amazing that the Government have managed to increase the funding for victim support. Personally—this is my view, not necessarily that of the all-party group—I think it was right to award the contract for looking after adult victims to the Salvation Army. I have seen the proposal and how it will spread a network of safe homes across the country, involving many different organisations. In a way, it is a big society solution to the problem. Although the POPPY project did an excellent job, it was very London-based. More victims will be looked after better by the new solution and I congratulate the Ministry of Justice on that.
	There is one great scandal on which we will continue to press the Government. Adult victims of human trafficking are looked after in this country, previously through the POPPY project and now through the Salvation Army, and they are put into safe homes and helped back into normal life. They can either go home to their country of origin or settle properly into this country and they are given help in bringing prosecutions against the dreadful people who do the human trafficking. It must be far worse for a child victim of human trafficking than for an adult. A young child, aged 15 or so, might be brought into this country having been told that they will have a job in a store, but might suddenly find that they are in a brothel and repeatedly forced to have sex. That must be far worse for a child than for an adult.
	What happens to those child victims? As a child, the local authority has to look after them, but there is no particular provision for local authorities to look after trafficked children. They do not even identify them—the provision is a bolt-on to the local authority system. All that happens is that these children are taken into care and then re-trafficked. That scandal must be sorted out. I am pleased that the Government have just awarded a grant to Barnardo’s to set up a safe-home system for children. Admittedly, there will be only 16 children to start with, but that has to be the way forward. We must treat trafficked children differently from ordinary children who come into local authority care. The all-party group will be pressing the Government on that issue over the next few months.
	I also welcome the Government’s four-pronged approach to trafficking and to setting the new goals. I also welcome the fact that they are taking time to reach a decision, as I would prefer them to take as long as possible and to get it right. I do not really care whether in Government terms the spring finishes at the end of July, so long as we get it right. There was much criticism of the Government before, saying that they would not opt into the EU directive, but they have done so. Now, there is a lot of chatter that the Government will make a mess of the strategy on human trafficking, but I do not believe that. I hope that when it comes before us we can have another debate and can push the Government further. We are clearly moving in the right direction.
	There are two issues about the directive that I want to mention which I think the Government are going to have to consider seriously over the next few months. The first concerns the rapporteur—I have only just learned how to say that word because it is foreign. It seems to me that the Dutch model is better than any of the others. It has a rapporteur and a secretary and they account for the whole cost of the system, so it is a minimal amount of money. The rapporteur reports
	independently to Parliament once a year on how trafficking is going in the Netherlands and how the Government’s policies work—that is her entire role. It would be really good if we could replicate that system in this country. Of course, I think that our first rapporteur should be Anthony Steen, who was in the Palace of Westminster earlier talking about this very debate, but whomever we might consider for the role, we should look into doing that.
	The second issue, which is perhaps more difficult, is the requirement under the directive to have guardianship. I shall be at No. 10 Downing street on Thursday, helping to deliver a petition about guardianship that I believe has more than 600,000 names as a result of a campaign by the Body Shop and ECPAT—End Child Prostitution, Child Pornography and Trafficking of Children for Sexual Purposes. This is a difficult issue—I do not want to pretend that it is not—but we have to get to grips with it and I hope that we in the all-party group can work with the Government to find a solution.
	The Government have done an excellent job on this and I respect the effort and time that the Ministers have put in, as well as the constructive criticism that has come from the Opposition. This is a night to celebrate, but I shall come back in future weeks to criticise.

Michael Connarty: It is a great pleasure to be here this evening to welcome the Government’s proposals. I know that we are going through the European scrutiny process and that we have a right to our debate, but there might be a small tinge or last flourish of Euroscepticism in the forcing of a debate after the date on which the Government had hoped to sign up to the directive. I have seen the letter to the Chairman of the European Scrutiny Committee, so I know that the Government have respected the scrutiny process and the Committee’s wish to have a debate on these issues. That is to be commended for scrutiny purposes and I do not think it will take anything from the eventual signing up to the directive.
	I once asked the Prime Minister about his moral compass in relation to this issue, and it seems that our collective moral compass has come through the magnetic storm of Euroscepticism and out the other side pointing in the right direction. I welcome that greatly. I do not think that the probing questions asked by those who perhaps did not want us to do things on the basis of an EU directive, but wanted us to set up 27 arrangements with other countries, were unhelpful because they made the Government think hard about what was in the directive. Some of the issues that I pressed hard on, such as extraterritorial jurisdiction, are very important and I hope that the Government might join the European Parliament in getting the same clause on extraterritorial jurisdiction into the directive on sexual exploitation and the abuse of children, as that is currently being resisted.
	We have done this just in time. The ECPAT and Body Shop petition has been running for some months and when I looked after it had been closed on 5 May it had 887,575 signatures calling for guardianships to be set up as part of our response to the trafficking of children. I believe that the petition will be presented on Thursday at No. 10 Downing street on behalf of those organisations. ECPAT has also been supported by the Body Shop financially in its work.
	A month ago, the Commissioner for Children and Young People in Scotland reported on his research into the trafficking of children. From the evidence he had collected, he said there were at least 80 cases he could verify and possibly 200 of which he had had notice. For a small country such as Scotland, that is a lot. If the figure were extrapolated for the UK, the number would be massive—much higher than the figure of 1,000 mentioned by my hon. Friend the Member for Slough (Fiona Mactaggart), and that is just for children. It worries me that there is a massive amount of trafficking going on—perhaps for the purposes mentioned by my right hon. Friend the Member for Leicester East (Keith Vaz), who talked about what he had seen in Romania. Clearly, there is a lot of trafficking going on that we have yet to find out about—much more than some estimates. Some of it might be just to reunite families; some of it might be for benefit fraud; some of it might be for exploitation through cheap labour or begging, as I have seen in other European countries; and some of it might be for other, more nasty, reasons, including sexual exploitation and abuse.
	We have a long way to go. According to the reports I have seen, there were only eight successful prosecutions for people trafficking in England last year. What seems to happen, according to the data that I have, is that the accused plead guilty to a lesser charge. There is not supposed to be plea bargaining in this country, but we know that it happens. The number of proper cases and final prosecutions is very low. There was one well publicised case of a woman police officer who pressed for research into human trafficking, because she had seen it going on, and was told by her senior officer, “We’re not interested in human trafficking. In this force we’re interested in burglaries.” In a case reported today by Barnardo’s, a judge commented to a 14-year-old who had been trafficked and used in a sex ring that it was just a lifestyle choice that she had made. That is frightening in this day and age.
	We have much to do about the scale of the problem. I sent the Minister a number of parliamentary questions. I was told that the trafficking toolkit from 2003 was available to all law enforcement agencies. That was the answer to my question about how many people had been trained by the police forces in this country to handle human trafficking. It was confirmed today by the people from Barnardo’s that only a quarter of police forces have proper child protection units running, so we have a long, long way to go.
	I have received information from contacts throughout the EU. The Human Trafficking Foundation run by Anthony Steen is keen that we should reach out and form organisations such as the one run by the hon. Member for Wellingborough (Mr Bone) in all the countries of Europe. For example, when I went to Hungary, I met representatives of three organisations who could give me lists of 400 women trafficked and re-trafficked—turned over, new women brought into Switzerland by one organisation, and children trafficked from Kosovo to Albania and elsewhere in that part of the world for begging, theft and possibly sexual abuse. It is important that we get round Europe, make contacts, recognise the scale of the problem and see it as a European problem and one that is much wider than the EU.
	We need a new approach to victims, as was said from the Front Bench and supported by the hon. Member for Wellingborough. We should realise that, if we can separate
	the victims from the traffickers, we can deal with the traffickers better, but when they are mixed up and it is suggested that those involved in prostitution rings are somehow accepting of it, we blur the images and people start to think that those in the brothels are the trouble and the problem. It is a massive money-making operation exploiting women as they have been exploited for generations, but now that is transnational and we must do something about it.
	We should take a new approach to the many active organisations. I do not know how the Salvation Army bid will work and who it will work with, but following the debates that we have had here on slavery and trafficking, I have been contacted by organisations that work with Moldova, for example, as my right hon. Friend the Member for Leicester East (Keith Vaz) mentioned. One organisation in London works with an organisation in Moldova trying to stop the young girls coming out of care homes being picked up immediately and offered work which ends up as prostitution in other European countries. We must break the cycle in the country of origin, as was said from the Government Back Benches. There are many organisations actively working in this field that we must pull together and see as a great force.
	Barnardo’s commented that sometimes the authorities think that people who act as guardians—that was not the term used, but the role is similar—looking after the women and children coming out of those rings are treated as though they are amateurs, because they are not professionally paid and they are not formal social workers. In fact, they are more highly skilled and have done more sensitivity training and skill training than many receive in their wide curriculum as social workers. We must start treating such volunteers as part of the force that we can turn to the advantage of those children.
	I will finish by making one further point, as the Under-Secretary of State for Justice, the hon. Member for Reigate (Mr Blunt) is present. We have had a debate on the EU directive on combating the sexual abuse of children. I hope that our Government, who do not have a statute of limitations on sexual abuse crimes, will persuade the EU that in its directive there should be no statute of limitations on those crimes. The current bid from the European Parliament is for a 15-year statute of limitations, which would expand provision in many countries. We need that to be taken out, so that when we catch a person involved in such crimes, at any time, they will be prosecuted and jailed.
	I have been made a UK representative of the Council of Europe’s ONE in FIVE campaign, which is intended to promote the Council of Europe convention on the protection of children against sexual exploitation and sexual abuse, which the UK has signed up to but not yet ratified. I think that we should ratify that convention. I hope that Members who are listening to the debate do not see this problem just as something that happens on their streets and that they have to worry about only in the context of their constituencies. Every time Anthony Steen went abroad with the European Scrutiny Committee, he took the chance to reach out by making contacts, talking about the issue and convincing people that they should join in and act as the all-party group does here, and I will do the same every time I go abroad. When Members who are listening to the debate are in contact with parliamentarians in other parts of Europe and beyond, they should talk not just about the positive things, but about the need to come together to shut down that
	network and protect the people who are exploited from country to country, for whatever reason. That will defend the people on our streets and in our communities much more than thinking that we can do it alone.

Mark Hendrick: The details of this European directive are to be welcomed. They will strengthen Britain’s ability to prosecute those who carry out these horrendous crimes and ensure that adequate care is provided for victims of human trafficking. This debate is taking place close to the 224th anniversary of the first meeting of the Society for Effecting the Abolition of the Slave Trade. On 22 May 1787, 12 men, led by Thomas Clarkson, met in a printing shop in London and sparked a movement that led to the abolition of the slave trade within the British empire in just 20 years.
	Human trafficking is a modern-day version of the slave trade. When people think of slavery, they think of 17th-century ships transporting Africans across the Atlantic. When children study slavery, they look at the role slaves played in the British empire or the impact slavery had on the American civil war. For many, the issue is resigned to the history books. However, the United Nations estimates that 12 million men, women and children are enslaved today. This is likely to be a conservative estimate, with the actual number closer to 30 million. In other words, slavery and human trafficking is very much a contemporary issue. The nature of slavery has changed dramatically, so it is important that we continue to review how we combat human trafficking.
	The changing nature of slavery can be demonstrated by a study conducted on the retail cost of a slave. The study looked at slavery over the past 4,000 years and concluded that in the period up to the 20th century, the average cost of a slave was around £24,000 in today’s money. After advances in technology and the population explosion of the past 100 years, the cost of a slave today is estimated to be around £55.
	Rather than being kidnapped, many of those enslaved today walk into it. They are searching for employment in order to improve their families’ lives. When a seemingly legitimate offer of moving away from home with the promise of a decent paid job is made, many take it. They give all their savings to groups or individuals who transport them thousands of miles away from home. However, they soon find that the job is not what they were promised, and when they try to leave, they are forced through violence, or the threat of violence, to stay. Given that they are often in a country illegally, with no documentation, they have no choice but to stay. Those who are most at risk from human trafficking are therefore among the world’s most vulnerable people. In addition to providing support and prosecuting those who commit criminal acts, we need to ensure that the root causes of why people become trafficked are addressed.
	In conclusion, the measures in the EU directive will strengthen our ability both to prosecute criminals and to support victims. Britain has a long history of leading and shaping international responses to issues such as human trafficking, a crime that is transnational and in all our interests to eradicate. I hope that Britain will continue to do that under this Government, and that any latent Euroscepticism will not get in its way.

Damian Green: We have seen that this is a matter of considerable importance to everyone in the House this evening, and there has been a remarkable degree of cross-party consensus. I am very reassured by the level of support for our intention to opt in to the directive. The right hon. Member for Leicester East (Keith Vaz) said that it was a unique experience for an Immigration Minister to receive unanimous support from the House, but I think that he was being characteristically understated: the House appears to have given unanimous support for opting in to a European directive. This debate may have been low key, but it is genuinely historic in that regard. In the last few minutes of it, let me address the points that have been raised.
	I am grateful for the support of the hon. Member for Slough (Fiona Mactaggart), who speaks for the Opposition. I smiled at her opening remarks, because I remember sitting in her position when the previous Government were deciding whether to opt in to the Council of Europe convention. I spent about 18 months urging them to, and I probably used exactly the same words as she did when I welcomed their decision eventually to do so. I take her point about wanting more referrals under the national referral mechanism, and, as several hon. Members on both sides of the House have said, the new national crime agency and the border command within that will be helpful in toughening up the whole response to trafficking, including the police response to the national referral mechanism.
	Several hon. Members questioned the police commitment in certain areas to fight trafficking, and there is more to be done. That is one reason why we are introducing the national crime agency, but in defence of the current system I should say that tackling organised immigration crime is the second-highest priority of the Serious Organised Crime Agency, after fighting drugs, so it is high on the list of those who fight organised crime.
	The hon. Lady mentioned the POPPY project, and the Under-Secretary of State for Justice, my hon. Friend the Member for Reigate (Mr Blunt) explained the new system, whereby there is not just a new provider in the Salvation Army, but a new process of using a prime contractor. Different contracting agencies will buy a range of skills, and I hope that that will make the new system less London-centric, as my hon. Friend the Member for Wellingborough (Mr Bone) rightly pointed out.
	There were also questions about protection at the railway border, St Pancras, where Eurostars arrive, but I should point out that Operation Paladin, a successful exercise run jointly by the UK Border Agency and the Metropolitan police, operates there, so it is not true to say that the station is a soft spot. Of course, all passengers on those trains will already have gone through controls in France or Belgium, too.
	The hon. Lady also asked whether the new protection regime would allow for the challenging of NRM decisions. All support providers are asked to, and helped to, provide information about victims’ experiences and circumstances to the competent authority precisely to ensure that the correct NRM decision is reached and to advocate on behalf of victims in the provision of services. That will continue to be the case under the new contract.
	I slightly parted company with the hon. Lady when she said that the process of coming to the new strategy had been slow and confused. I gently point out to her
	what she, as a former Minister, will know perfectly well: this is the first day for six weeks that the Government have been able to make policy announcements, because we have been in pre-election purdah. That is one reason why the definition of spring in Whitehall is reasonably elastic. We have this period every year when we simply cannot make announcements, but it is now coming to an end.
	I am grateful for the general support of my hon. Friend the Member for Carshalton and Wallington (Tom Brake). He asked about forced begging and criminal offences, but the directive requires the UK to criminalise only trafficking. The UK is already compliant with that requirement, subject to the requirements that I mentioned to amend our offences regarding extra-territorial jurisdiction and internal trafficking for labour exploitation. The required penalties for the offence of trafficking are as set out in article 4 of the directive. There is no requirement for any penalties specifically relating to forced begging or any other provisions about forced begging or other offences. I hope that that answers the question. He also talked about legal representation. In the UK, victims of crime are not a party to criminal proceedings and therefore do not need assistance with legal representation.
	My hon. Friend mentioned the role of the local press and the acceptance of adverts that many of us would prefer not to see in local papers. I completely agree with the points he made. It has always struck me that this is an example of where consumer power might be useful. If the readers of those newspapers told them that they found such adverts offensive and therefore would not buy the newspapers or products that were advertised in them, I dare say that newspaper groups would stop carrying those adverts.
	On the time scale, as I said, we are applying to the Commission to opt in because the directive has already been completed. The Commission has to decide within four months to let us in, which I presume will not be a problem, and then, over a period to be determined by the Commission—a number of years, possibly two—any primary legislative changes will need to be put through this House.
	I particularly welcome the remarks of my hon. Friend the Member for Wellingborough about the Salvation Army. I hope that this measure leads to a spread of expertise and a greater tapping into new expertise in helping victims. I am grateful for his kind remarks, and I echo what he said about Anthony Steen and praise his own successor chairmanship of the all-party group on human trafficking.
	The hon. Member for Linlithgow and East Falkirk (Michael Connarty) has developed great expertise in these matters. In response to his first remarks, we are seeing the scrutiny procedure working. The substance of this measure is very important, but the process is quite important as well. Proper parliamentary scrutiny of a European directive is leading to a good legislative result in this country, so this is good for Parliament as well.
	The hon. Gentleman talked about the number of convictions. Since May 2004, there have been 166 convictions for trafficking, including 153 for trafficking for sexual exploitation, of which three are for conspiracy to traffic. Since December 2004, there have been
	13 convictions for labour trafficking and six for conspiracy to traffic. Those figures all run to the end of January this year.
	Finally, I am grateful to the hon. Member for Preston (Mark Hendrick) for putting the matter in its proper historical perspective.
	The measures set out in the directive very much reflect the existing position in the UK and the work that we are already doing to combat human trafficking. Subject to Parliament and the Commission agreeing with our intention to opt in, I look forward to working closely with the Commission, the practitioners and our corporate partners to implement those measures. It is simply intolerable that in 2011 human trafficking still plagues this country. We should not rest until we have it under better control, and opting in to the directive will mark an important step towards achieving that aim. I commend the motion to the House.
	Question  put and  agreed to.
	Resolved,
	That this House takes note of European Union Document No. PE-CONS 69/10, relating to the Directive of the European Parliament and the Council on preventing and combating trafficking in human beings and protecting its victims, replacing Council Framework Decision 2002/629/JHA; and supports the Government’s intention to apply to opt in post-adoption under Article 4 of Protocol 21 on the position of the UK and Ireland in respect of the area of freedom, security and justice.

Business without Debate

DELEGATED LEGISLATION

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Companies

That the draft Companies Act 2006 (Consequential Amendments and Transitional Provisions) Order 2011, which was laid before this House on 3 March, be approved.—(Angela Watkinson.)
	Question agreed to.
	Motion made, and Question put forthwith (Standing Order No. 118(6)),

Climate Change

That the draft Greenhouse Gas Emissions Trading Scheme (Nitrous Oxide) Regulations 2011, which were laid before this House on 22 March, be approved.—(Angela Watkinson.)
	Question agreed to.
	Motion made, and Question put forthwith (Standing Order No. 118(6)),

Defence

That the draft Defence Science and Technology Laboratory Trading Fund Order 2011, which was laid before this House on 24 March, be approved.—(Angela Watkinson.)
	Question agreed to.

PUBLIC ADMINISTRATION

Ordered,
	That Mr Charles Walker be discharged from the Select Committee on Public Administration and Alun Cairns be added.—(Geoffrey Clifton-Brown, on behalf of the Committee of Selection.)

COUNTRY OF ORIGIN MARKING

Motion made, and Question proposed, That this House do now adjourn.—(Angela Watkinson.)

Gavin Williamson: It is a great privilege to open this important Adjournment debate. I must begin by declaring my interest, as outlined in the Register of Members’ Financial Interests.
	We are all passionate about developing our manufacturing base. It is vital that we, as politicians, do all that we can to promote British manufacturing and production to begin to rebalance our economy. I will place an emphasis on country of origin marking for manufactured products such as consumer goods, but I am sure that other Members will raise other areas.
	This debate comes at a useful time, because only last week or the week before, Stoves, the cooker manufacturer, released information from a survey it had conducted with consumers, which found that half of British consumers were baffled about what products were made in Britain and what products were not. It also showed that two thirds of British consumers wanted to see a “Made in Britain” mark on products. I could not agree more with that sentiment, except for one small point: it should not be “Made in Britain”, but “Made in Great Britain”.

Mark Spencer: I hope that my hon. Friend recognises that the food industry is different from other industries in that it is possible to make a chicken pie in Nottinghamshire using south American chicken, and say that it is made in the United Kingdom. Does he agree that there are many loopholes that need to be closed?

Gavin Williamson: My hon. Friend makes a pertinent point. The manufacture of chicken pies is not an area of speciality for me, but I am fortunate that in the village of Wombourne in my constituency, there is a McCain factory that produces some of the finest smiley faces in the world. Members will be pleased to hear that they are all made from British potatoes. It is not only McCain’s smiley faces that are important. British people want to see British brands manufacturing in Britain once more. We need to give those companies an incentive by making it clear what products are manufactured in Britain.

Chris White: Does my hon. Friend agree that if a customer is given more information, such as the country of origin, there is a high probability that businesses will move to countries with better records in ethics and sustainability?

Gavin Williamson: My hon. Friend makes an important and prescient point. I will go on to touch on the ethics of where products are manufactured.
	Forty per cent. of British consumers have stated that if they knew that products were made in Britain, whether they be food products or consumer products such as chinaware, glassware or clothing, it would influence positively their decision to buy those products. We want to promote manufacturing. If the Government can do anything to promote our products and encourage people to buy them, they need to do so.

Heather Wheeler: The Toyota plant at Burnaston is making the new hybrid Auris, and they are being branded as, “Made in Britain”. It is really interesting that manufacturers are starting to do that themselves.

Gavin Williamson: Absolutely. There is a real sense of pride. That pride was felt even by the Department for Business, Innovation and Skills when, not long after the general election, a JCB—another great product from my home county of Staffordshire—was proudly displayed in front of the Department in the full livery of a Union flag. Well, if it is good enough for BIS, I say it is good enough for the rest of the country.
	Britain is still a great manufacturing nation, despite the many years of decline and the fact that employment in manufacturing has declined from 4.3 million to 2.5 million. We should not be disheartened, because we can rebuild this great manufacturing nation and have a second industrial revolution, with manufacturing businesses spawned right across the nation—hopefully, most importantly of all, in South Staffordshire. I am sure all Members would agree with that.

Heather Wheeler: Or South Derbyshire.

Gavin Williamson: Yes.

Richard Bacon: Or South Norfolk.

Gavin Williamson: Anywhere with the compass direction “south” in its name.
	The Government can make the simple move of ensuring that all manufactured goods have country of origin markings. That can help in various sectors—food has been mentioned, but I particularly wish to point out chinaware, glassware, clothing, domestic electrical appliances and furniture. People would know when they made their purchases that they were buying British, supporting the British economy and making a real difference.

Guto Bebb: The manufacturing sector in my constituency is very small, but we do have a growing food production sector and are trying to add value to locally produced food. One of the big issues is that people want to buy ethically produced food and be sure that animals have been treated properly. In buying British, they know that that is the case. My hon. Friend’s points are therefore very important to the food sector in my constituency.

Gavin Williamson: I know that my hon. Friend has been involved in promoting all manufacturing businesses in his constituency, including a Welsh cake shop in Betws-y-Coed, which I am sure is there as a direct result of his interventions and help.
	My hon. Friends who have mentioned ethics touch on a vital issue. Country of origin marking makes it very clear where products come from and the standards to which they have been produced. I always notice, Mr Deputy Speaker, what a fine and wonderful suit you sport on occasions such as today. I can only imagine that it was manufactured by one of the finest tailors in all of Savile row, as you always look so elegant and wonderful as you sit there looking nobly over us all.
	Without a shadow of a doubt, that is a direct result of fine English craftsmanship. Many Members do not have sufficient income to support such fine wear, but when we go to the tailor’s, the gentlemen’s outfitters, Tesco or wherever we go to purchase our suits, we make our choice based on price, quality and design. We need transparency about where products come from.
	When I have been to China and Vietnam and seen some of the factories that produce consumer goods for the UK, I have seen that it is not just the wages that are different from those in the UK but the working conditions and the humanity with which the work force are treated. I did not think I would often make a speech in the House and find common cause with the TUC, but I agree that we need to tell people in Britain that when they buy something cheap, they are not paying a high price for it but other people are. We need to make it clear which products are British and which are Italian, German or from any other part of the world, such as China or Indonesia.

Justin Tomlinson: I congratulate my hon. Friend on an extremely passionate speech, which I am sure will gather much support throughout the House. I agree with his point about informing consumers, because in debate after debate, we are told that we need consumer power to influence matters. However, we can deliver that only if the consumer is informed, so I fully echo his comments.

Gavin Williamson: My hon. Friend touches on an important point. Indeed, supposing I went back to my old trade of being a potter and I set up a company called Gavin Williamson English Chinaware, what country does my hon. Friend the Minister think a plate sold by my company would have been produced in?

Edward Davey: I think my hon. Friend is asking a rhetorical question, and I would like him to give the House the answer.

Gavin Williamson: My hon. Friend gives a very wise response. The simple reality is that such a plate could come from any country. It would not have to come from England, which is a great tragedy, because that is misleading consumers. We should treat customers with honesty and dignity so that they can make their choices on prices, design, value and so much more.

Mark Spencer: My hon. Friend is being very generous with his time. There is a thirst among consumers for information. He makes a strong case about ethics, so would he support extending labelling to detail not just place of origin, but whether a food product contained genetically modified materials or whether a meat product was halal, so that the consumer could be informed?

Gavin Williamson: I am fearful, because as soon as we get on to meat products I am always at a disadvantage—I can talk about chinaware. My hon. Friend makes a point about the integrity of products, which is something that we need to encourage. We only have to look at Waitrose to see a business that puts the highest standards on telling its consumers where its products come from, and people reward it with their custom.

Richard Bacon: Let me help my hon. Friend on meat products, particularly pork products. Is he aware that 70% of imported pork in this country is produced overseas to standards that would be illegal here, yet it can still be packaged in a way that makes consumers believe that it is British?

Gavin Williamson: That is a great tragedy, and it is common not just in food manufacturing. So many of the products that we see on the shelves of so many retailers right across the country are passed off as British when actually they are not. They are often manufactured to far lower standards. We have to take a lead on this issue.
	I must confess that when I got this debate my heart fell slightly. In my heart of hearts I know that the Minister will probably not quite be able to give me answers that I so desperately want to hear coming from his lips—that he is a passionate believer in country of origin markings and that this is something that we will roll out as a Government, helping manufacturing businesses large and small, right across the country. I had a look through something that the Department for Business, Innovation and Skills had produced setting out some of its concerns. I know that the Minister always listens closely to Members of Parliament, as we want to guide him away from the sometimes, let us say, constraining influence of officials and give him some exciting information to go back and challenge them with.
	One thing that officials constantly say is that the benefits to consumers are questionable. I cannot understand how any official could ever say that the benefits to consumers were questionable, when all that we would be doing is telling them where products come from. What could be more pure, more innocent or more helpful to consumers than telling them about the integrity of the products that they are buying—that is, about whether they are right and true—or where they have come from? Officials will probably say that country of origin marking will increase costs. I assure the Minister that it will not, for the simple reason that companies that are significant producers in furniture manufacturing, domestic appliances, chinaware, glassware or other sectors will already have to do country of origin labelling if they want to export into the US, Japan, South Korea and China. I remember exporting an awful lot of chinaware to China, and I always had to put the country of origin on the product. There is therefore no extra cost to manufacturers, because we already do it.
	I spoke just this morning to the chief executive of Royal Crown Derby, Hugh Gibson. I asked him, “Why do you want this country of origin marking?” and he said to me, simply, “Gavin, on every piece of ware that I produce, I put my Royal Crown Derby back stamp on it, and proudly, ‘Made in England’.” He added, “Other producers put their back stamp on products but no country of origin. I can only assume that they are ashamed of where they produced that product.”

Jeremy Lefroy: My hon. Friend makes a powerful case. Does he agree that such labelling is in the interests of British exports? All around the world, whenever I pick up a coffee cup in a hotel, I automatically, as a true Staffordshire man, turn it over to see whether it has come from Staffordshire, whether from Steelite,
	Dudson or one of the other fine companies that the hon. Member for Stoke-on-Trent North (Joan Walley) so ably represents.

Gavin Williamson: We cannot forget that “Made in England” and “Made in Great Britain” have value for consumers in this country, but probably more so around the globe. If we are not seen jealously to guard the labels “Made in England”, “Made in Great Britain”, “Made in Staffordshire” or “Made in the West Midlands”, and show that they are important to us, why should they mean anything to the rest of the world? We need to show the world that we are proud of “Made in Great Britain”, but if we do not insist upon having such labels on our products, why should the world believe it?
	The Department for Business, Innovation and Skills will probably say that it is difficult to enforce such a provision. However, if we introduced it initially to some sectors and then further, it would be self-enforcing, because businesses that are involved in the manufacture of the product will be on to trading standards immediately if they see any products that do not have country of origin marking. I must speak very highly of Staffordshire trading standards. I am sure that it and Stoke-on-Trent trading standards and many others throughout the country would be very proactive in enforcing the measure and in ensuring that the law and writ of the land is obeyed by all.
	The Minister’s officials might say that businesses do not want such a measure, but manufacturers do. Oddly enough, retailers and importers do not want it, but 95% of companies that employ people to manufacture products in this country will say, “Yes, we want it. Yes, we need it,” because that labelling is showing our added value on the products that we produce in this country when we create British jobs.
	I should like to extend an invitation to the Minister. I shall put a week of my recess aside to take him around as many manufacturing businesses that produce goods in this country as possible, so that he can listen to every single one of them say, “Yes, we want country of origin labelling on products so that people know that ‘Made in Britain’ means something in this country.”

Joan Walley: With the hon. Gentleman’s permission, I was hoping to have the opportunity to make a few comments before the Minister speaks. I am just taking out an insurance policy to ensure that I do.

Gavin Williamson: Yes—I was just coming to the end of my speech.
	Finally, officials might be concerned about what message country of origin labelling sends out to the world. They might say that country of origin marking on our products says that we are not a free-trading nation. I assure the Minister that there is not a country out there that does not recognise Britain as one of the most laissez-faire nations in trade and promoting world trade around the globe. No one would doubt our commitment to that, and I am quite sure that no foreign nations would do so either. This is a real opportunity to send a message to British business, industry and manufacturing that we
	are proud of what they do, and that we value the British work force and British products. I therefore urge the Minister to support country of origin labelling.

Joan Walley: I congratulate the hon. Member for South Staffordshire (Gavin Williamson) not only on securing the debate, but on bringing it to the Chamber in the manner he did. In calling it a generic debate about origin markings, he not only talked about issues affecting the ceramic and pottery industry, which is of major concern to me as a representative of parts of north Staffordshire—as opposed to South Staffordshire, which he represents—but made it clear that this is an issue for all kinds of trade. Hopefully the food that we eat—whether labelled as genetically modified or for the quality of the pork, chicken or whatever—is all served off plates and ceramics made in and from Staffordshire. I am grateful, therefore, for the permission of the Minister and the hon. Member for South Staffordshire to speak briefly in this important debate and to put a few comments on the record.
	In Staffordshire, this debate has all-party support. MEPs on all sides have led the debate on the ceramics and potteries industry in the European Parliament. For that reason, I believe that the Minister has a particular opportunity to think again and perhaps to listen to some independent thoughts, as was the case in the preceding debate. Given the decision taken in the European Parliament approving a proposal for origin markings, it is possible for the UK no longer to oppose the idea in the discussions involving the Department for Business, Innovation and Skills. Objections to the proposal have been raised—by Germany, I think, as well as the UK—but we now have a unique opportunity not to be afraid of going along with what the European Parliament has said. It is in all our interests to have country of origin markings.
	For the potteries and ceramic industry, it is clear that this issue has been going on for far too long. Time is now available to debate this matter, and much progress has been made in Europe. From the point of view of jobs, it is certainly in our interests to have “Made in Britain” markings. Like my colleagues, I have been talking with the British Ceramic Confederation, which at times has been wholly in favour of this proposal. Some of its members have not been in favour, but perhaps they have been those who like to think that what is manufactured under their brand is not manufactured here. Nevertheless there are real issues about transparency. We hear so much about choice, and when people go out and buy a product, they want to be able to make an informed decision. They want information consistent with the best trading standards practice so that they can know what they are buying and where it was manufactured.
	By reconsidering their opposition to origin markings, the Government could give us the opportunity to enable British manufacturing in Stoke-on-Trent to proceed in the way it needs to. We have lost so many jobs in the pottery industry, and it is not in our interest for people buying ware—whether for wedding gifts or whatever—to have the impression that they are buying a brand-name product manufactured in Stoke-on-Trent, if it has been manufactured in the far east, the United Arab Emirates or elsewhere. I hope that the Minister will recognise the long-standing complaint and that the European Parliament
	has given its support to the proposal. Rather than kicking this idea into the long grass, the British Government have the opportunity to do what they say they want to do and support UK manufacturing, the importance of which the Chancellor has spoken about. Items of ceramic ware designed and manufactured in places with the best innovation need to have on their turn-it-over side an origin marking stating “Made in the UK” or “Made in Britain”, and ideally “Made in Stoke-on-Trent, Staffordshire” as well. If the Minister could look again at this issue, in the spirit in which the debate has been brought to the House today, we could really make some progress on it. I urge him to liaise with all the MPs and MEPs who have been working for so long on this campaign, to see what progress we can make.

Edward Davey: I congratulate my hon. Friend the Member for South Staffordshire (Gavin Williamson) on raising this issue and on the passion with which he spoke. I am aware of his background in the ceramics industry, and he has shown the House his knowledge this evening. Ceramics is a UK sector with a well-deserved worldwide reputation for the design and quality of its products. It is also a sector that has had to restructure, often painfully, to remain competitive and successful in the global marketplace. I am also aware of the importance that the UK ceramics sector attaches to the clear origin marking of its products, and its strong, consistent support for the European Commission’s proposal for an EU regulation on the compulsory labelling of certain imported products.
	I share my hon. Friend’s pride in products that are made in Britain. The Department for Business, Innovation and Skills is also proud of Britain, and we have been showcasing British design, engineering and manufacturing in exhibitions every two months in the entrance to the BIS headquarters across Parliament square at No. 1, Victoria street. Those exhibitions have been a celebration of the success of UK engineers and manufacturers. The companies’ products that were showcased were excellent examples of cutting-edge UK innovation and ones that were vital to contributing to a low-carbon future. The companies have come from a cross-section of UK manufacturing and, in the context of this debate, I am extremely pleased that one of the leading UK ceramics companies—Dudson, one of the world’s leading specialists in the manufacture of ceramic tableware—has been part of the showcase. Other UK ceramics producers have a similar global reputation. We are proud of British manufacturing, and my hon. Friend rightly referred to what the Chancellor of the Exchequer said in his Budget speech about driving the UK back into growth through proclaiming what is made in Britain, invented in Britain and designed in Britain.
	The Government are not opposed to labelling, or to labels such as “Made in England”, “Made in Scotland”, “Made in Wales” or “Made in Northern Ireland”. That is positive country of origin marking, and it should be done because UK manufacturers believe that it is the right thing to do, for themselves and for their customers. That does not need legislation, however; it can be done voluntarily. There is no legal bar to such marking, and many producers already do it. Of course, in most circumstances, there is no legal requirement in the UK or anywhere else in the European Union for goods to be
	marked with an indication of their origin, but producers may do so if they wish. If overseas competitors see origin marking as a marketing benefit, they will follow suit. It is essential for the consumer that any such labelling is clear and accurate, and does not mislead. Indeed, it is a criminal offence under the Consumer Protection from Unfair Trading Practices Regulations 2008 to give consumers misleading information. However, it is important to recognise that UK business, including the ceramics sector, operates in a global economy. The days when the majority of goods bought by British people were manufactured here have unfortunately passed. The UK is a trading nation, and it relies on open global markets, as I am sure my hon. Friend recognises. This provides consumers with benefits such as lower prices and greater choice through variety, quality and price of products.
	I agree about providing appropriate consumer information, but we must be clear about what is important to the consumer. A Eurobarometer survey across all 27 EU member states last autumn asked a number of questions about consumers’ purchasing attitudes towards country of origin labelling. I accept that the ceramics sector was not covered by the survey. However, in relation to textiles and clothing, 75% of those questioned said that origin did not affect their purchasing decisions. For electronic products, the figure was 68%. That is not to dismiss my hon. Friend’s comments; I simply want to highlight the need to be clear about how consumers rank price, design, brand name and origin in their purchasing decisions.

Gavin Williamson: Does my hon. Friend accept that country of origin labelling is even more important for luxury products, to which this country is increasingly geared to manufacture? That is why we need to be proud and specific about what is produced in this country and to protect that market.

Edward Davey: There is absolutely nothing wrong, as I have said, with British manufacturers being able to describe and label their products as “Made in Britain”. The question is whether or not they wish to do that; it is totally voluntary and there is nothing to stop them doing so.

Joan Walley: The Minister referred to the 2008 regulations, and I was very much involved in trying to get them on to the statute book. The point about having transparency and ensuring a level playing field is important. The real issue is that goods are being sold in a confused way, and consumers are buying products without realising that they are not manufactured, designed, decorated and so forth in the UK. They are paying large amounts of money, without knowing that the goods are being manufactured overseas. If our manufactured goods, when exported, have to have the country of origin indelibly marked on the underside of the wares or on the packaging, why can we not have the same rule applying in this country, which would not be inconsistent with the general agreement on tariffs and trade?

Edward Davey: As I said, the hon. Lady knows that British manufacturers are completely free to put country-of-origin markings on their products. Many of them, particularly in the ceramics industry, believe that so doing gives them a marketing edge. I will come on to
	deal with the European Commission proposal, which both the hon. Lady and my hon. Friend mentioned. It is important to do so because that is part of the policy debate on which we are focused.
	As currently drafted, the EC proposal would require the compulsory country of origin marking of certain imported, mainly consumer products. It might well be to this matter that my hon. Friend is directing his remarks. Let us be clear about what these products are. They include crushed and finished leather, including footwear components, saddlery and travel goods; textiles, clothing and footwear; ceramic products, glassware, jewellery, furniture and brooms and brushes. Those items are all defined by customs code classification. In the case of ceramics, the Commission proposal covers floor and wall tiles, tableware, kitchenware and giftware.
	The European Parliament, voting on the draft regulation last autumn, proposed that the scope should be narrowed to cover only end-consumer products. This would limit it to products subject to further processing or assembly in the EU, although some flexibility was proposed for certain textile and footwear components. At the same time, the European Parliament proposed adding to the list of products covered by the regulation: tyres for agricultural vehicles, tyres for forestry vehicles; certain inner tubes; metal fasteners such as screws, nuts and bolts; non-electric hand tools; furniture casters; and taps, cocks and valves.
	The House will perhaps understand from that list one of the reservations held by the UK about this proposal. It is the absence of any objective criteria for determining why a particular product is or is not within the scope of the proposed regulation. In our view, it is not enough that a particular EU industry believes that its imported competition should be origin-labelled. At the moment, the best the Commission have offered as “criteria” is where its consultation has shown that there was “value-added” by requiring origin marking. Even the Commission admits that this is a pretty loose criterion. The European Parliament has not even addressed the issue, so I invite suggestions from my hon. Friend—perhaps he is about to make one—and others, on what might constitute meaningful and objective criteria in this regard.

Gavin Williamson: I must confess that I am no expert on the numerous EU regulations, but I have always believed that this Parliament is sovereign. If we think that we have a good idea that will benefit British business—that consumer products coming into this country or manufactured in this country should have country of origin labelling—let us just ignore the EU, create our own Bill and put it on the statute book. I say we should just ignore Brussels, start from scratch and enact what we think will make a difference for Britain.

Edward Davey: I think that my hon. Friend misunderstands the position. It seems to be Brussels that agrees with him and, I am afraid, his Government who do not. I do not think that he can blame Brussels, and indeed I expected him to pray Brussels in aid. He, like Brussels—or some parts of it—wants to regulate, while the Government are saying that we want to think twice before adopting the regulatory route. I hope he recognises that the premise of his intervention is not entirely valid.

Mark Spencer: My hon. Friend the Member for South Norfolk (Mr Bacon) mentioned the pork industry. The United Kingdom Government introduced regulation of pork production that applied higher animal welfare standards to British pigs. By not labelling products that come from other parts of the European Union, we are effectively allowing meat from pigs that have been subject to poorer welfare standards to sit on shelves next to our pork and to command the same value.

Edward Davey: The position is quite complicated. We are discussing the current European Commission proposal about country of origin marking on goods imported from outside the EU. The hon. Member for South Norfolk (Mr Bacon)—whose point has been repeated by the hon. Member for Sherwood (Mr Spencer)—was referring to agricultural products imported within the European Union, from other EU countries. That involves a slightly different regime. The United Kingdom has supported a political agreement on the “Food information for consumers” dossier, and we are pleased to see that it has reached the second reading stage.
	I hope that the hon. Gentleman will not question me in much more detail, because this is a matter on which Ministers in the Department for Environment, Food and Rural Affairs are focusing. I think I have it made clear that his question relates to a different issue, to which a different approach is taken. I should add that my wife never allows me to buy any pork other than British, and that I would not want to do so anyway.
	The proposal that may well have sparked tonight’s debate was originally presented by the Commission in 2005. At that time, it provoked a very mixed response from member states. Many saw it as primarily a protectionist measure, because its origins lay in concern in the Italian textiles and clothing sector about imports from China. Others argued that there was a need to address persistent breaches of copyright and design protection in relation to consumer products. That was coupled with the view that consumers needed such information to avoid being misled about the origin of products. While the UK recognises the validity of all of those concerns, we do not believe that this proposal is the best way of addressing them, and we continue to have strong reservations about it.

Gavin Williamson: I too have some reservations. What I was trying to convey in my earlier intervention is that I would always be very sceptical about whether anything that came out of Brussels was a good idea. Why do we not put together our own set of proposals for Britain, building on what is good in the EU proposals, and put them on our statute book?

Edward Davey: I think that my speech will deal with many of the issues that my hon. Friend has raised. I am afraid that he is in danger of supporting the Brussels-based regulation while the Government support a British deregulatory approach, but I hope that as I continue my speech I may be able to win him round to our approach.
	As I have said, we have strong reservations about the proposal, but, unlike some member states, the UK does not oppose it outright. The Government have been ready to engage directly with the Commission and supporters of the proposal, notably Italy, and to explore ways forward. My Department consulted widely when
	the proposal was first issued. We consulted UK business and other interests, including other interests within Government, and that consultation has been repeated on a number of occasions to ensure that we remain abreast of the latest developments.
	A clear majority of UK interests were, and remain, opposed to the Commission’s proposal. They include the CBI, the British Chambers of Commerce, the British Retail Consortium, the hallmarking association, and a number of sector as well as consumer interests. Within Government, the UK Intellectual Property Office and Her Majesty’s Revenue and Customs have also consistently opposed the proposal.

Joan Walley: The objections largely come from retailers, who have a vested interest in being able to import without making the full information available, so there is not transparency at the point of purchase. Why will the Minister not listen to manufacturers such as Steelite in my constituency, which does everything the Government are asking yet cannot compete fairly?

Edward Davey: First, the views of British retailers and consumers are not to be discounted. Both this Government and the previous one have paid a lot of attention to getting a good deal for consumers in respect of competition policy and consumer policy. However, the list of business interests I set out a few moments ago included the CBI and the British Chambers of Commerce, who do not represent retail interests alone.
	The Commission’s proposal, while never formally withdrawn, is now actively back on the Brussels table. The European Parliament is pushing the proposal hard, deploying its new powers under the Lisbon treaty in the trade policy area. Last autumn, it gave its formal support to the proposal and proposed a series of amendments. The proposal is now back with the Council to consider, but there remain deep divisions between member states, close to a 50:50 split. Nevertheless, technical level discussions began in February and are ongoing in the commercial questions council working group. These involve trade policy and customs officials from the 27 member states. The UK is participating fully and constructively in these discussions. However, there has been resistance from the Commission to recognising that the trade policy landscape has changed since 2005. It has refused a request from many member states for an updated impact assessment, and I am sure my hon. Friend the Member for South Staffordshire agrees that regulations should have an impact assessment.
	A number of free-trade agreements have been negotiated by the EU over the last five years, all of which contain a provision explicitly prohibiting discrimination between EU-produced and imported products. Only recently, World Trade Organisation members raised concerns in Geneva about the compatibility of this proposal with WTO rules. While it is true that some other WTO members have country of origin requirements—in the case of the US, these are both long-standing and comprehensive—our research has not shown, as many claim, widespread comparable requirements in most other countries.
	The UK retains its position of having strong reservations, but however strong they might be, reservations are capable of being overcome. So far however, neither the Commission’s explanations nor the European Parliament’s amendments have allayed our concerns. Our main concerns in addition to those arising from our overall approach to new regulation and the absence of objective product coverage criteria, to which I have already referred, relate to the need for this regulation and the costs imposed on business and on public authorities. There are genuine issues in relation to trade mark and design breaches and mislabelling of imported goods from some sources, but the Commission has yet to demonstrate that this proposal adds anything other than an additional administrative and cost burden to existing EU legislation, which includes the EU intellectual property rights regulation and the unfair commercial practices directive. The latter makes it an offence across the EU for products to be labelled in such a way as to mislead consumers. This includes information about the country of origin of products.
	The proposal is also likely to impose increased costs on producers, distributors and consumers. We estimate the proposal could prove more costly than the Commission has claimed—experience in the North American Free Trade Agreement area suggests up to 2% of the sale price, which is twice the Commission’s estimate.
	There is a further important cost dimension in this time of public expenditure constraints. The enforcement regime would, despite Commission claims to the contrary, impose additional burdens on national customs authorities. The proposal envisages additional physical control at the border. This detracts from efforts to strike a balance between effective control and facilitating free movement of legitimate trade across borders. The increased resources needed to implement this regulation, for example, those relating to the need to make verification inquiries, to which not all countries are legally obliged to respond, could have a negative impact on the priorities of UK and other customs authorities in respect of tackling illegal drugs and dealing with alcohol, tobacco, and firearms.
	Finally, I wish to address the issue of consumer information. UK consumer interests have been opposed to the Commission proposal from the outset, partly because they consider existing provisions to be adequate but primarily because they saw it as a protectionist measure. Similarly, the Commission’s own consumer consultative group came out against the proposal. The proposal is still being considered by the Committees that scrutinise European legislation in this House and in another place. The Government have undertaken to keep them abreast of developments in Brussels, and I wrote to them last on 12 February with an update. I am sure that those Committees will also take note of tonight’s debate, particularly the passion with which my hon. Friend the Member for South Staffordshire introduced it. May I end by congratulating him on his remarks, on securing this debate and on ensuring that this House had a full chance to hear the arguments on both sides?
	Question put and agreed to.
	House adjourned.